EMPLOYEE VERIFICATION FORM

EMPLOYEE NUMBER: …………

MPHASIS DATE OF JOINING: ………………………

Please provide complete information / Details. Do not use short forms/Abbreviations.

All fields are mandatory.

PERSONAL DETAILS

Title (Mr./Mrs./Ms.) Name (First) (Middle) (Last)

Date of Birth
(MM/DD/YY)

EDUCATIONAL RECORD- Please mention your Highest Completed Education Details

College Name/Address

University Name/ Address

From (Month/Year) To (Month/Year) Student Id No./Enrolment No.

Type of Degree Graduation Date Subject Major

(Month/Year)

EMPLOYMENT SECTION: Please provide last 7 Years of employments details.

Ver No 1.1
Note: If Not Applicable for any employment, please mention as NA.

EMPLOYMENT 1 (LATEST – Will always be your current employer - Mphasis)

Employment History- Please mention your Mphasis Date of Joining

Company Name: Position Held:

Address (main office and branch where working) Company Telephone:

(With local area code)

Employment Period: Start Date (MM/YYYY) To Reported to (Name & Name of HR Manager
(Till Date) Position):

Whether employment is of permanent or temporary nature (Contract positions are temporary)

Permanent Temporary Employee Code/Personnel No

EMPLOYMENT 2

Company Name: Position Held:

Address (main office and branch where working) Company Telephone:

(With local area code)

Employment Period: Start Date (MM/YYYY) To Reported to (Name & Name of HR Manager
End date (MM/YYYY) Position):

Whether employment is of permanent or temporary nature (Contract positions are temporary)

Permanent Temporary Employee Code/Personnel No

Ver No 1.1
EMPLOYMENT 3

Company Name: Position Held:

Address (main office and branch where working) Company Telephone:

(With local area code)

Employment Period: Start Date (MM/YYYY) To Reported to (Name & Name of HR Manager
End date(MM/YYYY) Position):

Whether employment is of permanent or temporary nature (Contract positions are temporary)

Permanent Temporary Employee Code/Personnel No

EMPLOYMENT 4

Company Name: Position Held:

Address (main office and branch where working) Company Telephone:

(With local area code)

Employment Period: Start Date (MM/YYYY) To Reported to (Name & Name of HR Manager
End date(MM/YYYY) Position):

Whether employment is of permanent or temporary nature (Contract positions are temporary)

Permanent Temporary Employee Code/Personnel No

Ver No 1.1
EMPLOYMENT 5

Company Name: Position Held:

Address (main office and branch where working) Company Telephone:

(With local area code)

Employment Period: Start Date(MM/YYYY) To End Reported to (Name & Name of HR Manager
date(MM/YYYY) Position):

Whether employment is of permanent or temporary nature (Contract positions are temporary)

Permanent Temporary Employee Code/Personnel No

EMPLOYMENT 6

Company Name: Position Held:

Address (main office and branch where working) Company Telephone:

(With local area code)

Employment Period: Start Date (MM/YYYY) To Reported to (Name & Name of HR Manager
End date(MM/YYYY) Position):

Ver No 1.1
Whether employment is of permanent or temporary nature (Contract positions are temporary)

Permanent Temporary Employee Code/Personnel No

ADDRESS SECTION: Please Provide the details of last 7 YEARS of Address you have resided at along with the
period of stay (to be mentioned in MM-YY format)

Ensure that you are descriptive wherever necessary.

Address Details Complete Details of the Address with the Landmark From To
& Pin Code
MM/YY MM/YY

Current Address Till Date

Previous Address 1

Previous Address 2

Previous Address 3

Previous Address 4

Previous Address 5

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Permanent Address

Ver No 1.1