Confidential

APPLICATION FOR EMPLOYMENT

PERSONAL DATA
Full Name in block letters (expand initials):

First Name/Middle Name/Last Name (as per Aadhar card)

Position Applied: Date:

Department:

Pan Card No: Aadhar Card No:

Application No: if applied: UAN No:
Father’s Name:

Nationality Indian
Non-Indian Citizenship (Please mention if your holding
any other International Citizenship)

Date of Birth (dd/mm/yyyy)

Gender: Marital Status:

Male Married

Female
Unmarried
Non Binary
Maiden Name (applicable for married Woman)
Others
Do not wish to Disclose

Classification: Synchrony Confidential

 Confidential

Please attach any one copy of the given following documents

Emergency Contact Details

S.no First Name Last Name Relationship Phone Number

1)
2)

Permanent Residential Address

(Number and Street)

Land Mark:

Period of Stay- From To

Current Residential Address (Number

and Street)

Land Mark:

Period of Stay

Contact Telephone No. (Specify Mobile Number Email Address

Location Codes)

Current Permanent `

Classification: Synchrony Confidential

 Confidential

EDUCATIONAL VERIFICATION – 1
EDUCATIONAL RECORD- Complete education qualification Certificates(Please
attach Self-attested copy of 10th, 12th ,Degree, PG certificate- whichever is
applicable) Also Provisional Degree Certificate, Consolidated marks sheet & All
years mark sheets. If studied directly through University, by correspondence or
distance education, please mention clearly.

12th School or College

Name/Address

Graduation/PG University
Name/ Address

From To Graduated Program %/ Student Id

No./Enrolment No.
Class

Type of Graduation Date Subject Major

Degree
(month/year)
certificate,
diploma

Social Security Number (Mandatory if Studied in U.S.A)

Are you pursuing any higher studies/course, if yes please give the details?

Classification: Synchrony Confidential

 Confidential

EMPLOYMENT SECTION
Please give the details of previous employments.
Ensure that you are descriptive wherever necessary-e.g. If Company is closed do
mention it & also from when the company is closed.
Telephone number with specific location code. Employee Code/ID/Number is
Mandatory. If your previous employer did not provide the letter, please mention and
state reasons for the same.
EMPLOYMENT 1 (Latest)

Employment History-Please attach a self-attested copy of your appointment

/relieving letter/Service certificate for this.

Company Name: Position Held:

Address (main office and branch where Company Board Number

worked) Telephone:

Employment Period (dd/mm/yyyy) Reported to Others -

(Name &
FROM:
Position):
TO:
(pl mention the correct period)

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

temporary) –
Permanent - Employee Code/Personnel No:
Social Security Number (Mandatory if worked in USA):

Responsibilities:

Last Monthly Gross Salary Reasons for Leaving

(Please attach the self-attested copy of
your last pay slip.)

Can verification be done now? Yes No (Please mention reason below, if No)

Classification: Synchrony Confidential

 Confidential

EMPLOYMENT 2

Employment History-Please attach a self-attested copy of your relieving

letter/Service certificate for this.

Company Name: Position Held:

Address (main office and branch Company

where worked) Telephone:

Employment Period (dd/mm/yyyy) Reported to

(Name &
FROM:
Position):
TO:
(pl mention the correct period)

Whether employment is of permanent or temporary nature (Contract positions

are temporary)

Permanent - Employee Code/Personnel No:

Social Security Number (Mandatory if worked in USA):

Responsibilities:

Last Monthly Gross Salary Reasons for Leaving

(Please attach the self-attested copy
of your last pay slip.)

Classification: Synchrony Confidential

 Confidential

EMPLOYMENT 3

Employment History-Please attach a self-attested copy of your relieving

letter/Service certificate for this.

Company Name: Position Held:

Address (main office and branch Company

where worked) Telephone:

Employment Period (dd/mm/yyyy) Reported to

(Name &
FROM:
Position):
TO:
(pl mention the correct period)

Whether employment is of permanent or temporary nature (Contract positions

are temporary)

Permanent - Employee Code/Personnel No:

Social Security Number (Mandatory if worked in USA):

Responsibilities:

Last Monthly Gross Salary Reasons for Leaving

(Please attach the self-attested copy
of your last pay slip.)

Classification: Synchrony Confidential

 Confidential

EMPLOYMENT 4

Employment History-Please attach a self-attested copy of your relieving

letter/Service certificate for this.

Company Name: Position Held:

Address (main office and branch Company

where worked) Telephone:

Employment Period (dd/mm/yyyy) Reported to

(Name &
FROM:
Position):
TO:
(pl mention the correct period)

Whether employment is of permanent or temporary nature (Contract positions

are temporary)
Permanent - Employee Code/Personnel No:
Social Security Number (Mandatory if worked in USA):

Responsibilities:

Last Monthly Gross Salary Reasons for Leaving

(Please attach the self-attested copy
of your last pay slip.)

Classification: Synchrony Confidential

 Confidential

OTHER JOBS

OTHER JOBS: Have you performed any temporary job, odd jobs or any job that
doesn’t issue any letter of appointment or experience letters?
YES/ NO. If YES, specify below details:

Company Name: Position Held:

Address (main office and branch Company

where worked) Telephone:

Employment Period (dd/mm/yyyy) Reported to

(Name &
FROM:
Position):
TO:
(pl mention the correct period)

Responsibilities:

Company Name: Position Held:

Address (main office and branch Company

where worked) Telephone:

Employment Period (dd/mm/yyyy) Reported to

(Name &
FROM:
Position):
TO:
(pl mention the correct period)

Responsibilities:

Classification: Synchrony Confidential

 Confidential

LATEST/PREVIOUS REMUNERATION

Monthly Amount Rs. Yearly Amount Rs.

Basic LTA

HRA Medical

Conveyance Allowance Bonus

Special Allowance

Food Allowance

Transport Allowance

Other Allowance

Total Per month

Total Per Annum

Other Benefits Other Perks

Provident Fund

Gratuity

Superannuation

DECLARATION FOR EMPLOYMENT

I hereby declare that the foregoing statements are true to the best of my knowledge
and I understand that it will form the basis of contract of employment if I am
employed by the Company. If at a future date, it is found that any of the information
herein is false or incorrect in any material respect, the Company will have the right
to terminate my service without any notice or salary in lieu thereof.

Date: Signature:

Classification: Synchrony Confidential

 Confidential

Reference Check:

Personal Reference Details

Contact Number (landline

Name E-mail Occupation
and mobile) and Address

Professional Reference Details

Contact Number (landline Company Name and

Name E-mail
and mobile) Designation

Classification: Synchrony Confidential

 Confidential

DECLARATION (PRE/POST EMPLOYMENT CHECK)

I, ___________________________________________________, hereby consent to

undergo the background verification conducted by Vibrant Screen Private Limited,

appointed by M/s. Synchrony International Services Pvt Ltd to undertake the

background verification.

I, also understand and accept that background verification involves

checking/verifying any factual or historical details provided by me related to the

past and present which includes address, contact information, reference details,

previous employment details given, educational, social credentials, Court &

Criminal records, Nuisance challan cases etc, at the time of my joining the services

of the company.

I do understand that my employment is subject to recommendation of investigating

agency (Vibrant Screen Private Limited) I hereby forego the rights to challenge the

decision of M/s. Synchrony International Services Pvt Ltd

Signature:

Classification: Synchrony Confidential

 Confidential

CHECK LIST

List of documents to be attached for Police Verification. Please tick the appropriate
documents provided for us for the verification.

Passport size photos 3

Identity Proof

Driving License

Pan Card
Voter ID

Aadhar Card

Passport

Address Proof

Passport

Ration Card

Driving license

Aadhar Card

Signature:

Date:

Place:

Classification: Synchrony Confidential

 Confidential

CHECK LIST
List of documents to be attached. Please tick the appropriate.

1) Check Type 1
a) 10th & 12th - Marks sheets/Pass certificate
(Mandatory for official records) 
b) Graduation & Post Graduation (If applicable)
c) All semester mark sheets 
d) Final Year Marks Sheet 
e) Consolidated Marks Memo 
f) Provisional Certificate 
g) Convocation Certificate 

2) Check Type 2

a) Appointment letter 
b) Service Certificate 
c) Relieving Letter 
d) Salary/pay slip 

3) Check Type 3

a) Copy of Ration Card 

b) Copy of Voter ID card 
c) Copy of Passport 
d) Copy of Pan Card 
e) Copy of Telephone Bill 
f) Copy of Electricity Bill 
g) 2 Recent Passport Photographs 

Classification: Synchrony Confidential

 Confidential

Letter of Authorization

To whom it may concern

I hereby authorize M/s. Synchrony International Services Pvt Ltd, representative to

verify information provided in my resume and application of employment and to
conduct enquiries as may be necessary at the company’s discretion. I authorize all
persons who may have information relevant to this enquiry to disclose it to M/s.
Synchrony International Services Pvt Ltd, or its representative. I release all persons
from liability on account of such disclosure.

Signature :

Name in Capital :

Date :

Classification: Synchrony Confidential