viv Ltn Infosys’ ease A INFOSYS LIMITED Your tates Electonics City, Hosur Road, Bangalore - 550100, india Passport “Te: (080) 28520261, Fax: (080) 28520962 Photograph Hore Please ¥ inthe [] wherever applicable Please arswor each column fully and neatly in your own handing APPLICATION FOR EMPLOYMENT NAME IN FULL (in block laters) {As t appears on passport legal document) FiRst ‘MIDoLE last [ADDRESS FOR COMMUNICATION Mobile No. ° z E-mail lz (Personal El 1D any a Fy CITZENSHIP(S) 2 6 Fd F4 Fa 4 oy. DO YOU HAVE A PASSPORT 7 PIN / POSTAL CODE. ves No State County Day Time Contact No (Optra DATE OF BIRTH (as per passport legal document GENDER: (dlmninny) MALE FEMALE VER 82 tof3 HRDIRECIFIONG SIGNATURE OF THE APPLICANTeven xsT0 1s | eraouarion | gah eSion DP .EQUY, OTHERS ‘QUALIFICATION AWARDED STATE BOARD! UNIVERSITY NAME OF THE ScHOOL/ COLLEGE ‘BRANCH STREAM? [AREA OF SPECIALIZATION MARKS SCORED FORALL SUBJECTS / SEMESTERS Parry MAXIMUM MARKS PERCENTAGE /CGPA/ GRADE FOR ALL FINAL EXAMINATION GAPS IN EDUCATION (if any) years. Reason. PLEASE WRITE 'NA’IF NOT APPLICABLE, Specity clearly in case of pat tmelcontract work experience, Notice period required mm EXPERIENCE? ' reo REASON FOR| RELIEVING PAYROLL ORGANIZATION’ FROM | To |ourarion |DESIGNATION| SEBROATON| LETTER (ian months) CN). rm i] 2 fa 4 a a x Fay 4 z S ES ‘Are you under any legal obligation to your current employer: ves No IF YES, Please Spociy: * Please do specify “Payroll Organization” Ifyou are working on a contractual basis. Disclaimer: Please be informed that work experience provided by you will be validated through Background check VER 82 20f3 HRDIRECIFIOWS SIGNATURE OF THE APPLICANTsma. cunrent NEXTREVISION EXPECTED | YouR ExPEcTATION AT a are INFOSYS FAM Fix Sal 2 Fy EAE vercvie Pay z 4 1) 1) 1) 8 EM overseers | 2) 2 PA i 3 9). 3 2 Fa Fl Fe annua cross COMPENSATION WAVE YOU UNDERGONE ANY SELECTION PROCESS WITH INFOSYS OR INFOSYS GROUP VES No COMPANIES (LIKE INFOSYS BPO, ETC.) PREVIOUSLY ? IF YES, HAVE You Inrosys OTHER GROUP COMPANIES “TAKEN ANY TES ves[_] no No sevecreo rorinrerview? —YES[_] NO yes[_] No MADE AN OFFER ? YES No yes No EAM owen eau? yes[_] No yes] No i PAR) ARE YOU EMPLOYED AS: 1. ADIRECTOR / PARTNER INANY OTHER COMPANY? YES No FI Fai IF YES, PLEASE PROVIDE DETALS: EBD ce vou CURRENTLY EMPLOYED WITH ANY OF THE INFOSYS GROUP COMPANIES? yes NO ives, inrosysero[_]_orhers [] Please specty Have you at any tine been convicted by a court of nda or any cimnal ofance and sentenced toimprisonment, or any criminal proceedings are pending against you before @ court in India, Yes NO Gr has an order prhiing you apart Wom india, bow iaued by a cou yes, please give details ofthe same \alvie Ifoey te vrvuctinwesigtin to vey face of al siairerts made in th apponton and my waporing doouacts | authorize Infosys to secure Information about my experience from former employers, educalonal hstkwvons, government svtasttareralagetoecr ar etereppes ev provide, a br trove partes prove lermaten cmoeTone ny Gaoesore {or employment and hereby release al partes ftom any labity arin from sven vestigation FAM cert tative acacomicmarks/CGPAare sole average or allaubjets/ semesters years incusngeectves, optona subjects ESI ci.onal stojcsprociatsardarguages EE | understand that am employed wt the company, any false statement misrepresenation, or omission offacsanthis application trowary sipertrg doer, rperioes a hon diecovredi fous! to be fale: ay Tal hy armediee dorsal, The Be company wil nave the ght o withsraw my lle of appointment oo terminate my wainng/susequant apport at ary time FEA tout notice or compensation Fd Fy My signature below certifies that | have read, understand, and agrae tothe foregoing and to the best of my knowledge and belt the information on the application form is uo ane correc. Date: Place: Signature: VER 82 30f3 HRDIRECIFIONS