Interview Location

Kolkata(wb)

Candidate Id

1007733055

Please ✓ in the ❑ wherever applicable.

Please answer each column fully and neatly in your own hand-writing.

APPLICATION FOR EMPLOYMENT

PERSONAL DETAILS
NAME IN FULL
(in block letters)
(As it appears on passport / legal document)

ANUBHAV SAHA

FIRST MIDDLE LAST

ADDRESS FOR COMMUNICATION

rambadh Mobile No : +91-8668040808

Burnpur Pan Card No : XXXXXX194A

E-mail: a77926248@gmail.com

(Personal E-Mail ID only)

City ASANSOL CITIZENSHIP(S) :

PIN / POSTAL CODE 713325 Indian

State : West Bengal DO YOU HAVE A PASSPORT?:

YES: R NO: ❑
Country India

DATE OF BIRTH (as per passport / legal document) :

(dd/mm/yyyy) GENDER:

09/10/1999 MALE R FEMALE ❑ OTHER ❑

VER 9.3 1 of 4 HRD/REC/2024

SIGNATURE OF THE APPLICANT

 EDUCATION
LEVEL DIPLOMA/EQUIV GRADUATION POST OTHER
(If applicable) GRADUATION
(If applicable)
Name Of The Qualification Bachelor Of
Awarded Technology
State Board / University Srm Institute Of
Science &
Technology
Name of School/College SRM Institute of
Engineering and
Technology,
Chennai
Branch/ Stream / Area Of Computer
Specialization Software
Engineering
*Percentage / CGPA 8.5
Year & Month Of Final May 2021
Examination
*ALL PERCENTAGES / CGPA SHOULD BE AS PER THE DEGREE CERTIFICATE OR FINAL YEAR MARKSHEET (Documents
will be checked during interview round.)

GAPS IN EDUCATION (If any) 0 years. Reason: NA

WORK EXPERIENCE
PLEASE WRITE 'NA' IF NOT APPLICABLE
SPECIFY CLEARLY IN CASE OF PART TIME/CONTACT WORK EXPERIENCE NOTICE PERIOD REQUIRED : 60 Days

PERIOD (DD-MM-YYYY)
PAYROLL FROM TO DURATION DESIGNATION REASON FOR EXPERIENC
ORGANIZATION* (in months) SEPARATION E/
RELIEVING
LETTER
AVAILABLE
(Y/N)

BA Continuum India Pvt 24-06-2021 Till date 37 Software Engineer Career N

Ltd Advancement

Preferred work location : CHENNAI, MYSORE, KOLKATA(WB)

GAPS IN EXPERIENCE (If any) 0 years. Reason: NA

* Please do specify "Payroll Organization" if you are working on a contractual basis

Disclaimer : Please be informed that work experience provided by you will be validated through Background check

VER 9.3 2 of 4 HRD/REC/2024

SIGNATURE OF THE APPLICANT

 COMPENSATION AND BENEFITS
ANNUAL CURRENT NEXT REVISION YOUR EXPECTATION AT
EXPECTED DATE: INFOSYS
15-12-2024
Fixed Salary in Lakhs 8.22
(INR)
Variable Pay in Lakhs 0.00
(INR)
Other Benefits in Lakhs
(INR)
Annual Gross 8.22 8.22 10.50
Compensation in Lakhs
(INR)

MISCELLANEOUS
HAVE YOU UNDERGONE ANY SELECTION PROCESS WITH INFOSYS OR INFOSYS GROUP COMPANIES YES R NO ❑
(LIKE INFOSYS BPM, ETC.) PREVIOUSLY?

IF YES, HAVE YOU WITH INFOSYS

MONTH & YEAR

- TAKEN ANY TEST? YES R NO ❑ ................

- SELECTED FOR INTERVIEW? YES R NO ❑ ................
- MADE AN OFFER? YES R NO ❑ APR - 2021

- JOINED & QUIT? YES ❑ NO R ................

ARE YOU SERVING/ENGAGED AS A DIRECTOR, PARTNER, SOLE PROPRIETOR OR IN ANY OTHER YES ❑ NO R
EQUIVALENT POSITION IN ANY COMPANY, FIRM OR BUSINESS ENTITY?
IF YES, PLEASE PROVIDE THE DETAILS
ARE YOU CURRENTLY EMPLOYED WITH ANY OF THE INFOSYS GROUP COMPANIES? YES ❑ NO R
IF YES, INFOSYS BPM ❑ OTHERS ❑ PLEASE SPECIFY
HAS ANY WARRANT FOR YOUR ARREST OR SUMMONS FOR YOUR APPEARANCE BEEN ISSUED OR YES ❑ NO R
AN ORDER PROHIBITING YOUR ENTRY INTO OR EXIT FROM ANY COUNTRY, BEEN ISSUED BY A
COURT OF LAW OR ANY GOVERNMENTAL AUTHORITY?
IF YES, PLEASE PROVIDE THE DETAILS
HAVE YOU AT ANY TIME BEEN SUBJECT TO OR ARE BEING SUBJECT TO ANY INVESTIGATIONS BY YES ❑ NO R
THE FINANCIAL MARKET REGULATOR SUCH AS SECURITIES AND EXCHANGE BOARD OF INDIA?
IF YES, PLEASE PROVIDE THE DETAILS

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SIGNATURE OF THE APPLICANT

ARE YOU AWARE OF YOU BEING SUBJECT OF ANY INVESTIGATION BY ANY GOVERNMENTAL YES ❑ NO R
AUTHORITY?
IF YES, PLEASE PROVIDE THE DETAILS
ARE THERE ANY CRIMINAL PROCEEDINGS PENDING AGAINST YOU BEFORE ANY COURT OF LAW IN YES ❑ NO R
INDIA OR OUTSIDE INDIA?
IF YES, PLEASE PROVIDE THE DETAILS
ARE YOU SUBJECT TO ANY *SANCTIONS LAWS? YES ❑ NO R
[*SANCTIONS LAWS MEANS ALL APPLICABLE FINANCIAL, ECONOMIC AND TRADE SANCTIONS
(WHETHER PRIMARY OR SECONDARY), AND EXPORT CONTROL LAWS AND REGULATIONS (OR ANY
SIMILAR RESTRICTIONS) IMPOSED BY THE UNITED NATIONS OR THE GOVERNMENTS OF
AUSTRALIA, THE UNITED KINGDOM, EUROPEAN UNION AND THE UNITED STATES OF AMERICA OR
ANY OTHER COUNTRY]
IF YES, PLEASE PROVIDE THE DETAILS
ARE YOU UNDER ANY LEGAL OBLIGATION TO YOUR CURRENT EMPLOYER? YES ❑ NO R
IF YES, IN SIGNING THIS VERIFICATION AND AFFIRMATION REGARDING CONTRACTUAL
RESTRICTIONS, I AFFIRM THAT THERE ARE NO CONTRACTUAL RESTRICTIONS ON THE
ABILITY OF INFOSYS TECHNOLOGIES LTD. TO HIRE ME TO PERFORM THE POSITION FOR
WHICH I MAKE APPLICATION. I HEREBY AGREE TO RELEASE INFOSYS TECHNOLOGIES
LTD FROM ANY SUIT/CLAIMS MADE BY ANY OF MY PREVIOUS EMPLOYER(S) ARISING
OUT OF VIOLATION OF ANY CONTRACTUAL LEGAL OBLIGATIONS WITH THEM.

DECLARATION

I authorize Infosys to conduct investigation to verify facts of all statements made in this application and my supporting
documents. I authorize Infosys to secure information about my experience from former employers, educational institutions,
government establishments/agencies or any references I have provided, and for those parties to provide information
concerning my qualifications for employment and I hereby release all parties from any liability arising from such
investigation.

I certify that the academic marks / CGPA are simple average for all subjects / semesters / years including electives, optional
subjects, additional subjects, practicals and languages.

I understand that if I am employed with the company, any false statement, misrepresentation, or omission of facts on this
application or on any supporting documents, regardless of when discovered if found to be false, may result in my immediate
dismissal. The company will have the right to withdraw my letter of appointment or to terminate my training/subsequent
appointment at any time without notice or compensation.

My signature below certifies that I have read, understand, and agree to the foregoing and to the best of my knowledge and
belief; the information on the application form is true and correct.

Date : ........................... Place : .......................... Signature: .............................

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SIGNATURE OF THE APPLICANT