Background Verification Form

Bharti Airtel Ltd

Instructions: Please fill the form in BLOCK letters only and do not use any abbreviations
Personal Information
First Name BATTULA PAVAN KUMAR
Middle Name PAVAN KUMAR
Last Name BATTULA
Nationality INDIAN Please affix
your most
Gender Male Female
recent photo
Marital Status SINGLE here (if applicable)
Contact Number +91-8884442864
Email ID PAVANB2125@GMAIL.COM
Date of Birth 0 3 0 8 1 9 9 2
Father’s Name BATTULA JANARDHANA RAO
Identification Number 9135 6442 6039
Identification Type AADHAR CARD
Current / Permanent Address Details
House/Flat Number 19-148, FF 1
Building No. & Name SIVA BALAJI TOWERS
Address Line 1 SIVA BALAJI STREET,
Address Line 2 KALIDINDI VARI STREET, BALLEM VARI STREET,
Address Line 3 MURALI NAGAR
City VIJAYAWADA
Postal Code 520 007
State ANDHRA PRADESH
Country INDIA
Prominent Landmark NEAR RR CHICKEN
Period of Stay From 0 1 JAN 2 0 1 9 To M M Y Y Y Y
Contact Number +91-9246451479 ; +91-9394537962

Education - Highest Qualification

Name of Qualification Obtained POST GRADUATION DIPLOMA IN MANAGEMENT
Area of Specialization (s) MARKETING
Institution Name and Contact Details
NITTE SCHOOL OF MANAGEMENT
(School/ College/Institute)
Name & Address of University / Board AICTE (ALL INDIA COUNCIL FOR TECHNICAL EDUCATION)
Enrolment / Roll / Registration Number NSM 1418
Period of Study From 0 6 1 4 To 0 4 1 6
Year of Passing Graduated Yes No Pursuing
Course Attended Regular Evening Correspondence
 Employment Details
Fresher (Not required to fill this section) Experienced (Please fill this section as instructed below)
Employer 1
Company Name BACARDI INDIA PRIVATE LIMITED
Address Line 1 804-808,
Address Line 2 TIME TOWER
Address Line 3 MG ROAD
City GURGAON
Postal Code 122 009
State HARYANA
Company Phone No. 0124 4558800 Company Website WWW.BACARDI.COM
Designation SALES EXECUTIVE Supervisor Name
SALES Supervisor’s SALES MANAGER
Department
Designation
Remuneration (CTC - 7,50,000 RG@BACARDI.COM
Supervisor’s Email ID
PA)
112108 Supervisor’s Phone
Employee ID
No.
Date of Joining( e. g. 1 2 A P R 2 0 1 9 Date of 3 0 S E P 2 0 1 9
01-JAN-2018) Exit
Reason for Leaving LIQUOR TRADE HAVE BEEN TAKENOVER BY GOVT & LOOKED FOR AN OPPORTUNITY
Employment Type Full - Time Part-Time
Nature of Probation Permanent Contractual Temporary
Employment
Outsourcing Agency Details, if through contract

Employer 2
Company Name GLAXOSMITHKLINE CONSUMER HEALTHCARE LIMITED
Address Line 1 6TH FLOOR, KRM TOWERS
Address Line 2 NO:1, HARRINGTON ROAD
Address Line 3 CHETPET
City CHENNAI
Postal Code 600 031
State TAMILNADU
Company Phone No. 044 30571108 Company Website WWW.GSK.COM
TERRITORY SALES G. KIRAN TEJ BABU
Designation Supervisor Name
EXECUTIVE
SALES Supervisor’s AREA SALES MANAGER
Department
Designation
Remuneration (CTC - 6,08,448 GOLI.T.KIRANBABU@GSK.COM
Supervisor’s Email ID
PA)
6220343 Supervisor’s Phone
Employee ID
No.
Date of Joining( e. g. 0 1 N O V 2 0 1 8 Date of 0 4 A P R 2 0 1 9
01-JAN-2018) Exit
Reason for Leaving GSK ACQUIRED BY HUL 7 DUE TO JOB SECURITY PURPOSE CHANGED THE JOB
Employment Type Full - Time Part-Time
Nature of Probation Permanent Contractual Temporary
Employment
Outsourcing Agency Details, if through contract
 Letter of Authorization
To whom it may concern

I understand that the information provided by me may be used by any third party agency appointed by the
organization to verify and validate the information I have provided including my employment, my personal
background, professional standing, work history and qualifications etc.

I understand that the organization or the third party agency appointed by the organization may obtain information
it deems appropriate from various sources including, but not limited to current and past employers, criminal
conviction records, university / school / college records, professional and personal references and other verifying
sources / authorities.

I authorize, without reservation, any individual, corporation or other private or public entity to furnish the
organization or the third party agency appointed by the organization, all information about me.

I unconditionally release and hold harmless any individual, corporation, or private or public entity from any and all
causes of action that might arise from furnishing to the organization or the third party agency appointed by the
organization, that they may request pursuant to this release.
This authorization and release, in original, faxed or photocopied form, shall be valid for this and any future
references.

Signature

Name (In Block Letters) BATTULA PAVAN KUMAR

Father’s Name BATTULA JANARDHANA RAO

Date 28-10-2019