TATA BACKGROUND CHECK FORM IDB Check form Project Name: Comcast TCS Employee #: NIKHIL BHARATH TCS Current Location: CHENNAI ‘TCS Recruitment Branch: CHENNAT Designation: ASSISTANT SYSTEM ENGINEER Date of joining:27-01-2022 TRAINEE Name of the Applicant (Full name as in PASSPORT/PANCARD) NIKHIL BHARATH Contact Landline Phone “Mobile Phone no.:7989605700 email id:2237951 @tes.com 1no.:7989605700 Father's Name: Date of birth (Attach Proof): PAN | Marital Status: UNMARRIED ‘Nationality: INDIAN card ‘A. Present Residential Address : (Attach Proof) Period of Stay | From : 13-10-2007 | To: Till date Landmark: NEAR TAGORE STADIUM (€2-11,B zone,Ramakrishnapur, Mandamarri City/Town:Mancherial State: Telangana Pin code: 504301 B. Other Residential Address: [Furnish other addresses of your residence in the last seven (7) years] Other Residential Address 1: Other Residential Address 2: Other Residential Address 3: From To: Till From To: From To: date i i City/Town: City/Town: City/Town: State: State: State: Pin code: Pin code: Pin code: Landmark: Petrol bunk Landmark: Landmark: Attach Additional Sheet, if you have stayed in more than 3 Other Residential addresses (locations) C.Permanent Address: (Attach Proof) Period of Stay | From: 13-10- To: Till date Landmark:Near tagore stadium 2007 ‘Same as present Address City/Town: Mancherial State: Telangana Pin code:504301 Contact Landline Phone no,:9949349304 Mobile Phone no.: 9949349304 ‘Note: Proof of docs to be attached - Passport (First & Last page) / PAN Card ‘TCS Confidential Background Check Form — Experienced Professionals (EP) V1 Ensure consistency with information furnished by you initially in TCS Appl ion 5.0 Page 1 of 2 don FormTATA Declaration and General Consent to Background Investigation To be signed by the Applicant In connection with my application to render services to Tata Consultancy Services Ltd (the "Company’), | hereby agree as follows: | certify that the information furnished in this form as well as in all other forms filled-in by me in conjunction with my employment is factually correct and subject to verification by TCS including Reference Check and Background Verification. | accept that an appointment given to me on this basis can be revoked and/ or terminated without any Notice at any time in future if any information has been found to be false, misleading, deliberately omitted/ suppressed. As a condition of Company's consideration of my application for employment with the Company, | hereby give my consent to the Company to investigate or cause to be investigated through any third parties my personal, educational and pre or post employment history. | understand that the background investigation will include, but not be limited to, verification of all information given by me to the Company. | confirm that the Company is entitled to share such investigation report with its clients to the extent necessary in connection with the Services, which I may be required to provide to such clients. | confirm and undertake that the Company shall incur no liability or obligation of any nature whatsoever resulting from such investigation or sharing of the investigation results as above. | certify that | am at present in sound mental and physical condition to undertake employment with TCS. . | also declare that there is no criminal case filed against me or pending against me and | have not filed any criminal case against someone that is closed or pending in any Court of law in India or abroad and no restrictions are placed on my travelling anywhere in India or abroad for the purpose of business of the company. | Agree : Yes Signature NIKHIL BHARATH. Name ____NIKHIL BHARATH TCS Employee ID. 2237951 Place MANCHERIAL. Date 19-05-2022, ‘TCS Confidential Background Check Form — Experienced Professionals (EP) V1 Ensure consistency with information furnished by you initially in TCS Appl ion 5.0 Page 2 of 2 don FormST fant AR Wee SE TAUERENT “> ~=GOVT. OF LINDA : caret char ten are ig Permanent Account Number Card a CMGPB0043J ral Name NIKHIL BHARATH fact eT ara! Father's Name SRINIVAS BHARATH sinh wtainaem - NVR 23/10/1998 . earare/ Signature 16012018