BACKGROUND CHECK FORM Business Associates (BA)

Guidelines /Checklist
 Fill-up the BGC Form completely and accurately with copies of all relevant supporting documents as proof
 Ensure consistency in information furnished by you initially in TCS Application Form

(1) Tick on the boxes below before submitting the BGC form, ensuring that you have submitted all required documents.
(2) No BGC forms will be accepted in the absence of any of the required documents as mentioned below.

Mandatory General Requirements:

 Signed & Attached Document on General Consent to Background Investigation

Letter (BGC Consent Letter enclosed within the BGC form)
 My recent Passport size photograph pasted at the appropriate place
Address Check & Criminal Check Requirements:

 Complete & Correct Address filled-in as required in BGC Form with Flat/Room No. clearly mentioned
 Prominent landmark near the address mentioned for easy location
 Self-attested & signed - Document for Address Proof submitted
 What could be submitted for Address Proof?
o Proof for Present & Permanent Address to be attached
o Provide Separate Proof, if address is different
o Attach copy of any one of the following documents as Proof for Address

(a) Ration Card (b) Electricity Bill (c) Landline Telephone Bill (d) Mobile phone bill
(e) House Lease Agreement (f) Aadhar Card

o Address Proof – For House Rental Agreement

 Copy of Agreement submitted (If Agreement signed between you and Owner)
 Copy of Agreement + Declaration Letter in Stamp Paper from Agreement Holder
(Blood Relation) stating that I am residing in the same address as mentioned in
the Agreement (If Agreement signed between your Family Member (Blood
Relation) and Owner)
 Letter from Society of the address (If Agreement signed between any other person
(Non-blood Relation) or you are staying in Bachelor’s Accommodation)

ID Check Requirements

 Self-attested & signed - Document for ID Proof submitted

 What could be submitted for ID proof?

(a) Valid Passport (b) Driving License (c) PAN Card (d) Aadhar Card (e) Voter’s ID card

TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 1 of 10
Ensure consistency with information furnished by you initially to TCS
 Reference Check Requirements – For each Reference

 References provided are either Supervisor/Person holding Responsible Position in a reputed

Organization
o No Relatives/Friends to be mentioned
o Reference to know Applicant for a minimum period of 2 years
 Full Name & Address of References provided legibly
 Contact email ID & telephone numbers of References provided
o Provide atleast two contact numbers

Educational Check Requirements

 Self-attested – copies of Highest Degree /Provisional Degree submitted

 Self-attested – copies of all Highest Degree mark sheets attached
 Self-attested – copies of SSC, HSC \ Diploma mark sheet’s & certificate

Previous Employment Check Requirements:

 Self-attested – copies of the documents from BA Company

o Offer letter – Mandatory
o Deputation letter

 Self-attested - Documents for all Previous Employment Proof submitted

 What could be submitted for Previous Employment Proof?
o Relieving Certificate from your Previous Employer(s) - Mandatory
o Experience Certificate & Salary Certificates – Last 3 months – Mandatory
o Offer Letter & Relieving Certificate
o Bank statement with Bank seal\signature as proof of salary deposited
o PF statement / PF number assigned by the previous employer(s)

Note: Your BGC Status will be Positive only after successful completion of employment checks
Including your Current Employer

Gaps during Education / Employment Check Requirements:

 Self-attested & signed – Documents to explain gaps during Education/Employment

 What could be submitted as Proof for gaps during Education/Employment?

o Affidavit (on 100 RS Stamp paper) with Notary Authorization for total gap above 6 months

Applicant to please detach and destroy this checklist while submitting the completed BGC Form

TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 2 of 10
Ensure consistency with information furnished by you initially to TCS
 BACKGROUND CHECK FORM Business Associates (BA)
Total Work Experience : 6 Years Have you served as BA in TCS earlier?
NO
Total Gap (Break) during / If yes, mention your BA No. assigned
between Education / Employment : earlier :
1 Year
Name of the Applicant (Full name expanding initials): SUPRIYA RAMCHANDRA GAIKWAD

Father’s Name: RAMHANDRA KAKASO GAIKWAD Mother’s Name :RAJSHREE

BA Company Name: Webscript Technlogies Pvt. Ltd. TCS Joining Branch:

Designation: Business Analyst Date of Joining: 3rd Jan 2023

Contact Landline Phone No.
Date of Birth (Attach Proof):
13/07/1992
PAN No : BTIPG7284G
Mobile Phone No. 9742658575 Email id:
Supriya.gaikwad.r@gmail.com
Marital Status: Married Nationality: Indian
Aadhar No : 906885454948

A. Present Residential Address : (Attach Proof)

Period of Stay From : 29th Jun To: Current Landmark: Kishor Tailors
2020
Supriya Gaikwad, W/O Kapil Harish Patil, Atma Balu Patil Wada, Nagav-Kavthe
Tal: Tasgaon, Dist: Sangli
City/Town: Sangli State:Maharashtra Pin code:416307
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: From : To: From : To:

City/Town: City/Town: City/Town:

State: State: State:
Pin code: Pin code: Pin code:
Landmark: 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 : 13/07/1992 To: 29/07/2020 Landmark: Ram Daji, Near water
tank
Supriya Gaikwad, D/O Ramchandra Gaikwad(Ram Daji) At/post: Balawadi,
Tal.: Khanapur, Dist: Sangli
City/Town: Khanapur State: Maharashtra Pin code:415307
Contact Landline Phone no.: Mobile Phone no.:9172822339

TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 3 of 10
Ensure consistency with information furnished by you initially to TCS
 Reference Details:
Details Reference 1 Reference 2
Reference Name (No Relatives/Friends Shashank Bhudta Melaram Sharma
to be given as Reference)
Title & Designation: Director at Transforme Foods Production Manager at Sriveda
(Supervisor/Person holding responsible Pvt. Ltd. Sattva Pvt. Ld. (Art Of Living
Position in a Reputed Organization.): Organization)
Is the above mentioned Reference/
Supervisor from the current Company No No
Full Address (with Company Name): No. 37, Ram Nagar, Wadgaon Melaram Sharma, Manager at
Sheri, Vadgaon Sheri, Pune - Sriveda Sattva Pvt. Ltd.
411014  21st KM, Udayapura Post,
Kanakapura Rd, Bengaluru,
Karnataka 560082
Contact details Official email ID: Director@transformefoods.com melaramsharma@srisritattva.com
Landline Telephone No.:

Mobile Phone No.: 9049000956 7829822923

Period for which the Reference knows the Since Jul 2016 April 2017
Applicant (Minimum 2 years)
Relationship with the Applicant Director and Reporting Manager Reporting Manager
(No Relatives/Friends)
Passport Details (Attach Proof):

(i) Name as in Passport: ……………………………………………………………………….

(ii) Passport No: ………………………………(iii) Place of Isuue;…………………………...

(iv) Date of Issue:………………………………(v) Date of Expiry:…………………………

TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 4 of 10
Ensure consistency with information furnished by you initially to TCS
Educational Qualifications (Attach Proof)
Name as in Certificate:

Qualification Highest Degree Qualification prior to Highest Degree

Mode of Education BE(Computer Sience) Diploma(Computer Science)
(Full time/Correspondence/Partime):
Name of Examination Passed (B.E./M.Tech, Savitribai Phule Pune University, Pune Maharashtra State Board
etc.):
CS And Tech. Computer Science
Specialization / Main Subjects:

G. H. Raisoni college of Engg. And Managment Adarsh Institute Of technology, Polytechnic

Name of Institute / College /
University:

Address: Gat No. 1200, Domkhel Road, Adarsh Institute Of technology, Polytechnic, Vita
(Give Complete Address)
Wageshwar Nagar, Wagholi Sangli Road, Near MIDC, Tal: Khanapur
Institute / City/Town: Pune City/Town: Vita
College /
University State: Maharashtra State: Maharashtra
Details Pin code:412207 Pin code:415311
Landmark: Nagar Road Landmark: Tasgaon Road
Office Landline Ph No.: 9604787185 (02347) 229021
Name of Affiliated SavitriBai Phule Pune University Maharashtra State Board
University:
Affiliated University Pune Kolhapur
Location:
Date From: Sep 2012 Jul 2009
Period of Study Date To: Jun 2015 Jun 2012
Seat No. / Roll No./ Regn No.:
Year of Passing: 2015 2012
% of marks & Class / Grade obtained:

TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 5 of 10
Ensure consistency with information furnished by you initially to TCS
Employment Details (Starting from your Current/Immediate Last Employment) (Attach Proof):
Name of the BA Company : Stratosphere IT Services

Previous Employer’s Description Current BA Company Previous Employment 1

Period Date of emp. From: Jun 2021
Date of emp. To: Oct 2022
Employee Designation: Business Anayst
Details Employee #: 1045
HR HR Name: Sunitha M Prashant Shinde
Details HR Designation: HR Manager Director and HR Process Head
Office Landline Ph No.: 040-67485435 Do not provide Mobile Ph No 9561654899 Do not provide Mobile Ph No
Email: Sunitha.m@stratosphere.co.in Prashant@Webscript.co.in
Supervisor Supervisor Name: Ashutosh Mishra Prashant Shinde
Details Supervisor Designation: AVP Director
Office Landline Ph No.: 120-4395750 Do not provide Mobile Ph No 9561654899 Do not provide Mobile Ph No
Email: ashutosh@stratosphere.co.in Prashant@Webscript.co.in
Last drawn CTC: 4 LPA
Reasons for leaving: Income Growth
Employer Employer Name: Stratosphere IT Services Pvt Ltd Webscript Technologies
Details
Address: H,409, 4th Floor Manjeera Trinity Corporate 1838, Sadashiv Peth,
(Give Complete Sr no-1050, plot no 5, JNTU Hitech city road Kusum Nivas, Vandemataram Chauk,
Address incl.
KPHB 3rd phase Kuketpelly Pune
Postal code,
prominent
landmark) Town/City – Hyderabad Town/City - Pune
State:Telangana Pin Code:500072 State:Maharashtra Pin Code:411030
Office Landline Ph No.: Do not provide Mobile Ph No 9561654899 Do not provide Mobile Ph No
Company Status: Is company currently functioning? Yes/No Is company currently functioning? Yes

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Ensure consistency with information furnished by you initially to TCS
 Previous Employer’s Description Previous Employment 2 Previous Employment 3
Period of Date of emp. From: Jan 2020 Apr 2017
employment Date of emp. To: Jan 2021 Aug 2019
Employee Designation: Product Success Executive and consultant Production Supervisor
Details Employee #: 20012 E216
HR Details HR Name: Ashish Sampath Suprith
HR Designation: HR Manager HR Executive
Office Landline Ph No.: 9845629972 Do not provide Mobile Ph No 08067976701 Do not provide Mobile Ph No
Email: Ashish.sampath@sumerusolutions.com Suprith.hr@srisritattva.com
Supervisor Supervisor Name: Kishlay Raj Melaram Sharma
Details Supervisor Designation: Developer and project head Prduction Manager
Office Landline Ph No.: 9845629972 Do not provide Mobile Ph No 08067976701 Do not provide Mobile Ph No
Email: Kishlay.raj@sumerusolutions.com melaramsharma@srisritattva.com
Last drawn CTC: 3 LPA 2.3 LPA
Reasons for leaving: Internal Switch During Covid To switch with Software Department
Employer Employer Name: Sumeru Software Solutions And Global Support Sriveda Sattva Pvt. Ltd.
Services
Details
Address: Sumeru Software Solutions, Samvit Building Sriveda Sattva Pvt. Ltd.
(Give Complete 21st KM, Udayapura Post, 21st KM, Udayapura Post,
Address
Kanakapura Rd, Bengaluru, Karnataka 560082 Kanakapura Rd, Bengaluru, Karnataka 560082
incl. Postal code,
prominent landmark)
Town/City: Bengaluru Town/City:Bengaluru
State:Karnataka Pin Code:560082 State: Karnataka Pin Code: 560082
Office Landline Ph No.: 9845629972 Do not provide Mobile Ph No 08067976701 Do not provide Mobile Ph No
Company Status: Is company currently functioning? Yes Is company currently functioning? Yes

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Ensure consistency with information furnished by you initially to TCS
 Previous Employer’s Description Previous Employment 4 Previous Employment 5
Period of Date of emp. From: Jul 2016
employment Date of emp. To: March 2017
Employee Designation: Operational Manager
Details Employee #: 01
HR Details HR Name: Shashank Bhutda
HR Designation: Director
Office Landline Ph No.: 9049000956 Do not provide Mobile Ph No Do not provide Mobile Ph No
Email: Director@transformefoods.com
Supervisor Supervisor Name: Shashank Bhutda
Details Supervisor Designation: Director
Office Landline Ph No.: 9049000956 Do not provide Mobile Ph No Do not provide Mobile Ph No
Email: Director@transformefoods.com
Last drawn CTC: 1.56 LPA
Reasons for leaving: Personal
Employer Employer Name: TransforMe Foods Pvt. Ltd.
Details
Address: No. 37, Ram Nagar,
(Give Complete Wadgaon Sheri, Vadgaon Sheri, Pune - 411014 
Address Near Anjali School
incl. Postal code,
prominent landmark)
Town/City:Pune Town/City:
State:Maharashtra Pin Code:411014 State: Pin Code:
Office Landline Ph No.: 9049000956 Do not provide Mobile Ph No Do not provide Mobile Ph No
Company Status: Is company currently functioning? Yes Is company currently functioning? Yes / No
Note: (i) You may attach additional sheets, if required, to provide more details on your Previous Employments

TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 8 of 10
Ensure consistency with information furnished by you initially to TCS
 Gaps during Education/Employment (Attach Proof):
From To Reasons for gap
Jul 2015 Jun 2016 Result waiting, Taking Communication Improvement and
Gap Period 1 personal development training

Sep 2019 Dec 2019 career switch

Gap Period 2

Gap Period 3

Gap Period 4

Gap Period 5

SECURITY DETAILS:

A, Are you involved in any pending and / or closed Civil / Criminal / case /
proceedings / charges / enquiry prior to joining TCS ?
No
B, Are you involved in any pending and / or closed Disciplinary / malpractices and
/ or any other charges / proceedings / enquiry / case pending against me in any
University or any other educational authority / institution prior to joining TCS ?
No
C, If the answer to any of the above mentioned questions is ‘ Yes’ give full particulars of the case /arrest /
detention
/ fine / conviction / sentence / punishment etc. and / or the nature of the case pending in the Court /
University / Educational Authority etc., at the time of filling up this form.(Attach additional sheet, if
required)

DECLARATION (To be signed by the Applicant)

I certify that the information furnished in this form is factually correct and complete in all respects to the
best of my knowledge and belief.

Signature of Applicant Supriya Gaikwad Name Supriya Gaikwad

Place Mumbai Date 26/12/2022

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Ensure consistency with information furnished by you initially to TCS
TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 9 of 10
Ensure consistency with information furnished by you initially to TCS
 Declaration and General Consent to Background Investigation

Declaration to be signed by the BA

In connection with rendering services to Tata Consultancy Services Ltd. (the "Company"), as a Business
Associate (BA) from
Stratosphere IT Services Pvt Ltd (BA Company), I hereby agree as follows:

I certify that the information furnished in this form as well as in all other forms filled-in by me in conjunction
with my rendering of services as a BA is factually correct and subject to verification by TCS including
Reference Check and Background Verification.

I accept that my services as a BA 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 rendering of services as a BA to the Company, I 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, criminal history and any other checks, including
Drug test as required for complying with TCS and or Client specific BGC requirements. I understand that the
background investigation will include, but not be limited to, verification of all information given by me to the
Company. I 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. I
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.

I certify that I am at present in sound mental and physical condition to undertake my rendering of services as
a BA with TCS. I also declare that there is no criminal case filed against me or pending against me 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.

I hereby declare and undertake that

I shall not resort to any unethical, unfair practices to augment my chances of selection with TCS by adopting
unlawful means directly and / or indirectly within and outside TCS and shall strictly adhere to the selection
process made applicable by TCS

My candidature for Contract Services in the Company is liable to be rejected in the event it comes to the
knowledge of TCS that I have resorted to unethical, unfair practices to augment my chances of selection with
TCS. I am fully aware that TCS is an equal opportunity employer and the decision of TCS to hire me is solely
will be made on my credentials duly validated and on the assessment of my capability to perform a role for
which I am interviewed by TCS.

I Agree : Yes

Signature : Supriya Gaikwad Name : Supriya Gaikwad

Place : Mumbai Date : 26/12/2022

TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 10 of 10
Ensure consistency with information furnished by you initially to TCS