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Candidate

Declaration Form – Manappuram Finance

Instructions: Please provide all the information requested in this form. Incomplete
Candidate Declaration Forms (CDFs) will be returned. All supporting documents must
accompany this form. Photocopies must be legible. We have included a checklist to
assist you to complete your application comprehensively.

PERSONAL DETAILS

Full Name (First/Middle/Last): ______________________________________________

Fathers Name: __________________________________________________________________________

Date of birth (DD/MM/YY):_______________ Personal Number:____________________Nationality:


_____________

Passport Number: __________________Date of issue: _____________________Date of expiry:


_________________

PAN Number / Social Security (If worked/studied in the US/Any other Country) __________________________

Change of Name if Applicable

Former Name/Maiden Name _____________________________ ________________________________

Date of Name Change ___________________________

Current Address Permanent Address

Door No/Street:__________________________ Door No/Street:____________________________


City:_____________________________________ City:________________________________________
State:____________________________________ State:______________________________________
Pin:_____________________________________ Pin:________________________________________
Landmark:________________________________ Landmark:___________________________________
: (Landline)_____________________________ :(Landline)____________________________
Is your residence your own or a rented place? _____ Is your residence your own or not? __________
If rented, please provide details of the Landlord Name: If Not, please provide details of the Landlord
___________________________________ Name: ___________________________________
Address: _________________________________ Address: _________________________________
City: _____________________________________ City: _____________________________________
State: ___________________________________ State: ___________________________________
Pin: __________________________ Pin: __________________________
: (Landline)______________________________ : (Landline)_____________________________
Note: Please attach legible
photocopies of any of the
following address proofs,
relevant to the entries above –
1. Last Paid Phone Bill. 2. Receipt of Last Rent Paid.
3. Social Security Number, or any other Country’s issue of SSN. 4. Passport / DL / Voter Id.

EDUCATION DETAILS

Highest Qualification (Course Completed)

Name of the Institute


Name of University
Affiliated with
Duration of Course
(Yrs.)
Student ID No./
From……………………
Enrolment No./
(Month and the Year)
Seat No./
To……………………….
(Month and the Year)

Division Class Degree Obtained

Course Type
Subject Major
(Full Time / Correspondence)
Address of Institution
(Only fill in the details asked for to
the right)
City

 (Landline) 1  (Landline) 2

Note: Please attach legible copies of the following documents relevant to your entries in the form. (Xerox only)

1. Educational Mark Sheets / Certificates.


a. Highest Education all year mark sheets & degree certificate or provisional certificate.
EMPLOYMENT DETAILS

NOTE: There are two categories in each form. Please provide information under the relevant Employment
Category.

(EMP-1) Last Employment


PERMANENT EMPLOYMENT
Name of Company
Where were you employed?  Registered Corporate  Branch Office
Office
Company Address Door No/Street
(Where you were City State
employed )
Pin  (Landline)
Period of employment Employee Code
Designation Remuneration
Department Reported to
Supervisor’s Designation  (Email Id)
CONTRACTUAL EMPLOYMENT

Company Name
Company Address Door No/Street
City State
Company Contact Person  (Email Id)
Designation  (Landline)

State your reason for


leaving
Note: Please attach legible
photocopies of the following
documents relevant to the
entries above
1) Appointment Letter 2) Salary Slip 3) Release Letter 4) Service Certificate

Address Verification

Complete Address (with


Landmark)
Period of Stay
(DD/MM/YYYY) From: To:

Note: Address for which verification has to be conducted.

Documents Required –

1. Address proof for the above address

Criminal Verification – Court Record Check By Law Firm

Complete Address
Period of Stay
(DD/MM/YYYY) From: To:

Note: Mention the address for which Court Record verification to be conducted
Document Required – Address Proof
for the above address

Authorization/ Declaration and Undertaking

Manappuram Finance Ltd, I agree to provide copies of all relevant certificates. I understand that
If Employed with
employment with Manappuram Finance Ltd is governed by their employment policies as applicable, including
satisfactory information from background checks.

I hereby certify that all information provided herein, is true and complete to the best of my knowledge and belief. I
authorize Manappuram Finance Ltd and its representative to authenticate information I have provided in my resume
and this Candidate Declaration Form (CDF). To conduct enquiries as may be necessary at the company’s discretion, I
authorize all who may have information relevant to this enquiry to disclose it to Manappuram Finance Ltd and/or its
representative. I release all concerned from any liability on account of such disclosures.

I also declare that the information provided by me in my resume and application for employment at Company Name and
its representative is authentic and I am liable for all inaccuracies and omissions.

I promise to extend total co-operation and provide relevant documents required.

Full Name of the Candidate: Signature of the Candidate

Place:

Date: