EMPLOYEE INFORMATION FORM

Name VISHNUVARTHAN SHANMUGAM

Date of Birth 18-12-1991

Place of Birth COIMBATORE

Gender Male Female

Nationality INDIAN

Marital Status MARRIED

Personal Details

Family Details

Father’s Name SHANMUGAM

Father’s Contact Number +91-9842490624

Mother’s Name KOUSALYA

Mother’s Contact Number +91-8838739026

Sp0use’s Name ABINAYA VIJAYALAKSHMI SARAVANAN

Spouse’s Contact Number +971-544033094

Passport & Visa Details

Passport Number S9607238

Place of Issue COIMBATORE

Date of Issue 03-12-18

Date of Expiry 02-12-28

Visa Status

Validity of Current Visa

Contact Details

Permanent Address (Line 1) 5, MANI COMPLEX, VCV NAGAR

Permanent Address (Line 2) THOPPUPALAYAM, PERUNDRAI, ERODE

TAMILNADU, INDIA-638052
Permanent Address (Line 3)

Permanent Contact Number

Residence Address (Line 1)

Residence Address (Line 2)

Residence Address (Line 3)

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EMPLOYEE INFORMATION FORM

Residence Contact Number

Vishnuvarthangem91@gmail.com
Email Address
ABINAYA/KOUSALYA
Emergency Contact Name
+971-544033094/+91-8838739026
Emergency Contact Number
SPOUSE/MOTHER
Relationship with the person

Driving License Details

License Number Type of License Place of Issue Date of Issue Expiry Date

Education Details

Level of Marks Passing

University / School Description of Degree
Education (% / Grade) Year
Masters
ANNA UNIVERSITY/VIDHYA Diploma BACHELOR OF ENGINEERING-
MANDHIR INSTITUTE OF 8.01/10 2015
Bachelors MECHANICAL
TECHNOLOGY
School
DIRECTORATE OF TECHNINAL Masters DIPLOMA IN AUTOMOBILE 91/100 2010
EDUCATION/RAMAKRISHNA ENGINEERING
MISSION POLYTECHNIC COLLEGE Diploma
Bachelors
School
STATE Masters SSLC 85/100 2007
BOARD-TAMILNADU/GOVERNME
NT BOYS HIGH SCHOOL Diploma
Bachelors
School
Masters
Diploma
Bachelors
School

Employment History

Organization Country of Type of Position Title Period Reason for

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EMPLOYEE INFORMATION FORM

Employment Employment (MM/YY –

Leaving
MM/YY)
Permanent
Part
ESTIMATION 04/2019-
NAFFCO UAE Time/Contr
ENGINNER 03/23
act
Intern
INDIA Permanent
Part DESIGN &
05/2015 –
SAFE FIRE INDUSTRY Time/Contr ESTIMATION For Car
03/19
act ENGINEER
Intern
INDIA Permanent
Part
SALES 05/2010 – FOR HIGHER
CEASE FIRE Time/Contr
ENGINEER 04/2012 STUDIES
act
Intern
Permanent
Part
Time/Contr
act
Intern
Permanent
Part
Time/Contr
act
Intern

Reference Details

Reference Check 1 Reference Check 2

Company Name

Full Name

Job Title

Relationship with the Employee

Enclosures

Resume Enclosed Yes No

Education Certificated Enclosed Yes No

Declaration
I understand that any employment by Telectron or its affiliated companies is conditioned upon positive responses

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EMPLOYEE INFORMATION FORM

from my references, bonding eligibility, continued adherence to Telectron policies and procedures, applicable rules
and regulations and job performance satisfactory at all times toTelectron.

I consent to take any pre or post-employment examinations as may be required by Telectron or its representative,
and release Telectron from any liability that may arise from such examination.

I authorize an inquiry to be made on the information contained on this application. Former employers and officials of
education institutes, named on this application are authorized to give information about me and I release them from
all liability for issuing such information.

I hereby attest and warrant that all my answers on this application as well as on all forms completed in conjunction
with my employment are true and accurate. I understand that my misrepresentation of facts, failure to disclose
information required on this application or material change in my information provided which is not reported to
Human Resources shall be cause for dismissal regardless of when discovered by Telectron.

Documents Required - Mandatory

For Education Verification:

 Photocopy of the degree certificate and final year mark sheet would be required.

For Employment Verification:

 Photocopy of relieving/experience certificate

For Identity Verification:

 Photocopy of Passport

Employee Signature & Date

For Human Resource
Employee’s Status:
Unlimited Contract

Limited Contract

Intern
Employee’s Information:

Job Title

Job Grade

Salary

Line Manager

Department

Location

Operating Company

Director – HR’s Signature & Date

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