PRE-QUALIFICATION

DOCUMENTATION

Candidate Background Checking Form

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 PRE-QUALIFICATION
DOCUMENTATION

Candidate Background
Checking Form
Name of the Candidate :
Address Details: (permanent/Local)

Father's Name: Contact No.:

Date of the Birth (dd/mm/yyyy): / / Gender : M / F

Name of the Company No -1

(Start with latest employer)

Company address
(Where you were employed)
Land Line :

From: / /
Period of the employed Employee Code :
(dd/mm/yyyy)
To : / /
Department /
Designation Division :
Last Salary Drawn
Person You reported to Name : Designation :

Direct land Line No.: Mobile No.:

Reporting Manager Contact
Details E mail ID :

Name of the Company No – 2

(Start with latest employer)

Company address (Where you

were employed) Land Line :

From: / /
Period of the employed Employee Code :
(dd/mm/yyyy)
To : / /
Department /
Designation Division :
Fixed Compensation (PA) : Variable (PA) :
Last Salary Drawn
Annual :
Person You reported to Name : Designation :
Direct land Line No.: Mobile No.:
Reporting Manager Contact
Details E mail ID :

Professional References Professional References 1 Professional References 2

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 PRE-QUALIFICATION
DOCUMENTATION

Name of the Person

Organization Name and

Designation

Mobile :- Mobile :-
Contact Details E mail ID :- E mail ID :-

• I Certify that the statement made in this application are valid and complete to the best of
my knowledge. I understand that false or misleading information may result in termination
of employment.
• If upon investigation, any of this information is found to be incomplete or incorrect, I
understand that I will be subject to dismissal at any time during my employment.
• I hereby authorize ICOM and/or any of its subsidiaries or affiliated, and any persons or
organization acting on its behalf to verify the information presented on this application form
and to procure and investigation report for that purpose.
• I hereby grant authority for the bearer to access or to be provided with full details of my
previous record.

• I hereby release from liability all persons or entities requesting or supplying such
information.

• I authorize to contact my present and past employer.

• I have read, understand, and by my signature consent to these statement.

•
• I have never been convicted for any criminal offence or received a caution, reprimand or
warning and no criminal case is registered against me.

Full Name : Date :

Signature : Place :

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 PRE-QUALIFICATION
DOCUMENTATION

AL - ITTEFAQ STEEL
PRE-QUALIFICATION
DOCUMENTATION

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