PERSONAL DETAILS

Please fill in the details with utmost attention, as these shall be verified by Cognizant
Technology Solutions and/ or by its authorized representatives.
All details are compulsory.

Name of Applicant:

Surname:

Employee ID:

Fathers Name:

Date of Birth (dd/mm/yy):

Marital Status:

Place of Birth:

Nationality:

Sex: Male

Passport No.:

Middle:

Home Phone: STD

Code
Number
Office Phone: STD Code:
Number:
Mobile:

E-mail id:
Address details for Last 2 years:

Residential Addresses 1:
CURRENT ADDRESS :

Pin Code:

City:

State:

Duration of Stay:
From (mm/yy)To
(mm/yy):

Nature of location: Rented, Own, Other (Specify):

Phone No.:

Residential Addresses 2:
PREVIOUS ADDRESS :
Pin Code:

City:

State :

Duration of Stay:
From (mm/yy) To
(mm/yy):

Nature of location: Rented, Own, Other (Specify):

Phone No.:

Permanent Address (Mandatory):

PERMANENT ADDRESS :
Pin Code:

First:

City:

State:

Phone No.:

Duration of Stay:
From (mm/yy)To
(mm/yy):

Nature of location: Rented, Own, Other (Specify):