BACKGROUND VERIFICATION FORM – (COMPANY NAME)
Please provide complete and correct information with utmost attention, all these shall be
verified by authorized representatives.
PERSONAL DETAILS
First Name: Saquib Middle Name: Asif Ali
Applicant Name Last Name:Khan
Gender: Male Date of Birth:19/10/2001
Female
Father’s Name:Asif Ali Khan Nationality:Indian
Email Id:saquibk2001@[Link] Mobile No: 9082731178
RESIDENTIAL ADDRESS
Current Address
A1 sankalp building flat no 207,Lohiya nagar near milan subway vile parle
west
City:Mumbai State: Maharashtra
PIN Code:400056 Duration of Stay
From (mm/yy):
To (mm/yy):
Permanent Address
Same as current address
City: State:
PIN Code: Duration of Stay
From (mm/yy):
To (mm/yy):
EDUCATIONAL DETAILS (HIGHEST CERTIFICATION)
College Name:Rizvi College Of Arts College Address:Bandra west near
Carter road
Group: Major Subject:Finance
From:2021 Regular
To:2023 Part Time
Copy of Certificate Submitted.
EMPLOYMENT HISTORY
Current Employer
Company Name:Geib loyalty card Address: Geib Loyalty Card Services
services L.L.C.. Emitac Building,office no 302
Employee ID: Designation:Relationship Department:sales
officer
Work Period Full Time Last Drawn Salary:
th
From:26 june 2025 Contract Basis
To:
Reporting Manager Name Email Mobile No.
& Designation: ID:[email protected]
Vishal om
Attached Employment Proof
Experience Certificate Relieving Letter Payslips Any Other
Previous Employer (1)
Company Name: Address:
Employee ID: Designation: Department:
Work Period Full Time Last Drawn Salary:
From: To: Contract Basis
Reporting Manager Name Email ID: Mobile No.
& Designation:
Experience Certificate Relieving Letter Payslips Any Other
Previous Employer (2)
Company Name: Address:
Employee ID: Designation: Department:
Work Period Full Time Last Drawn Salary:
From: To: Contract Basis
Reporting Manager Name Email ID: Mobile No.
& Designation:
Experience Certificate Relieving Letter Payslips Any Other
DECLARATION
I hereby declare that all the information provided here is true and complete to the
best of my knowledge and belief. I promise to extend total cooperation and provide
relevant documents if required.
Place:
Date: Applicant’s Signature