employee pre-joining declaration form

GRADUATION/
DIPLOMA/ PREVIOUS
EMPLOYMENT
DECLARATION FORM

DECLARATION ON
RELATIVES IN
KOTAK GENERAL
INSURANCE LIMITED

CONSENT FOR
CREDIT
VERIFICATION &
CIBIL DETAILS

EMPLOYEE PRE- INFORMATION ON

JOINING DISMISSAL,
DISCHARGE OR
TERMINATION FROM
DECLARATION PREVIOUS
EMPLOYMENTS

FORM
DOCUMENT DESCRIPTION
This document covers the pre-joining declaration for all
potential employees KOTAK MAHINDRA
GENERAL INSURANCE
LIMITED
27 BKC, C 27, G Block,

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 employee pre-joining declaration form

GRADUATION DECLARATION FORM (MANDATORY IF YOU ARE A GRADUATE)

Are you a graduate? YES  NO 

Year of passing graduation _____
Graduation Course Type
______________________
(Please mention “Full time” or “Part time” or “Correspondence” or “Open University”)

Year of passing HSC/ 12th standard _____

Course Type
______________________
(Please mention “Full time” or “Part time” or “Correspondence” or “Open University”)
Year of passing SSC/ 10th standard _____

I confirm that all details provided above are correct and authentic. I will produce all the original documents (and
not true copy) at the time of my joining Kotak Mahindra General Insurance Limited as evidence, failing which I
authorize the company to take suitable action against me, including dismissal from services.
Signature:
Name:
Date:

DIPLOMA DECLARATION FORM (MANDATORY IF YOU ARE A DIPLOMA HOLDER

AFTER SSC OR HSC)
If you are a graduate and have filled the graduation declaration form (above), you do not need
to fill this diploma declaration.
Are you a diploma holder? YES  NO 
Year of obtaining diploma _____
Is the duration a one, two, three or four year diploma? _____
Is the Diploma a part time diploma or full time diploma or Correspondence diploma? _____
Year of passing HSC/ 12th standard
Course Type
______________________
(Please mention “Full time” or “Part time” or “Correspondence” or “Open University”)

Year of passing SSC/ 10th standard _____

I confirm that all details provided above are correct and authentic. I will produce all the original documents (and
not true copy) at the time of my joining Kotak Mahindra General Insurance Limited as evidence, failing which I
authorize the company to take suitable action against me, including dismissal from services.

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 employee pre-joining declaration form

Signature:
Name:
Date:

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 employee pre-joining declaration form

PREVIOUS EMPLOYMENT DETAILS DECLARATION (MANDATORY FOR ALL

CANDIDATES)
I also confirm that all the details mentioned by me in my bio-data /CV/Resume with respect to my previous
employment, last drawn salaries and years of experience are True & Correct as per my knowledge.
I will produce all the original documents (and not true copy) at the time of my joining Kotak Mahindra General
Insurance Limited as evidence, failing which I authorize the company to take suitable action against me,
including dismissal from services. I also authorize Kotak Mahindra General Insurance Limited to do a reference
check of all the details provided by me at the time of applying.
Signature:
Name:
Date:

CONSENT for CREDIT VERIFICATION

To,
Kotak Mahindra General Insurance Limited, Mumbai.
This is in reference with my application for a suitable position in Kotak Mahindra General Insurance Limited. I am aware
that the organization offers various benefits like an emergency loan etc. when these become due/ applicable/ approved. I,
therefore, authorize Kotak Mahindra General Insurance Limited to conduct any necessary verification towards this,
including a CIBIL check, or any other credit verification.

Yours truly,
Signature:
Name:
Date:

DECLARATION on RELATIVES EMPLOYED in KOTAK MAHINDRA GENERAL

INSURANCE LIMITED
I DO NOT have any relatives* working as employees or agents for Kotak Mahindra General Insurance Limited/
Kotak Old Mutual Life Insurance Limited.
Signature:
Name:
Date:
* Relative is defined as mother, father, mother in law, father in law, brother, sister, brother in law, sister in law, son, step son,
daughter, step daughter, husband, wife

Kotak Mahindra General Insurance Limited reserves the right to take strict action, including dismissal from
services, if this declaration on relatives is found to be false or inaccurate.

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 employee pre-joining declaration form

DECLARATION OF SELF/IMMEDIATE FAMILY AS GENERAL INSURANCE

ADVISOR/AGENT
Do you have any immediate family member as an Advisor or Agent with Kotak GI or any other
General Insurance Company?
NO  YES  If YES, please Share following details of the person:

Name:
__________________________________
Contact No:
__________________________________
Permanent Address: __________________________________
__________________________________

* Relative is defined as mother, father, mother in law, father in law, brother, sister, brother in law, sister in law, son, step son,
daughter, step daughter, husband, wife

INFORMATION ON DISMISSAL, DISCHARGE OR TERMINATION FROM PREVIOUS

EMPLOYMENTS
Have you ever been dismissed or discharged or terminated or laid-off in any of the organizations you worked

for? Please mention details below

If no information is provided, it will be assumed that you have never been dismissed or discharged or terminated or laid-
off in any of the organizations you worked for. Kotak Mahindra General Insurance Limited reserves the right to take
strict action including dismissal from services if after reference checks, this information is found to be untrue or
inaccurate.
Signature:
Name:

CIBIL CHECK DETAILS

Excel attached with mail.

FINAL CHECKLIST FOR CANDIDATE REFERENCE

1. Updated CV copy in DOC/ PDF format YES

 NO 
2. Last 3 years appraisal letter [including CTC details]
YES  NO 

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 employee pre-joining declaration form

3. Last 2/3 years bonus letters YES  NO


4. Last 3 months pay-slips YES  NO

5. Graduation/ Diploma & previous employment declaration
YES  NO 
6. Information on relatives in Kotak Mahindra General Insurance Limited
YES  NO 
7. CIBIL declaration form & personal details for CIBIL verification
YES  NO 
8. PAN CARD scan copy YES  NO


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