TCS EMPLOYMENT APPLICATION FORM

Personal Details :

EP Reference # : EP2010RA547824

Source of Recruitment : Placement agency

Name : Mr. Jaya Kumar

Father's Name : Mr. Hari Haran

Date of Birth : 20/09/1984 Gender : M

Nationality : India Country of Residence : India

Passport # :

Date of Issue : Valid Upto :

Place of Issue : ECNR Check :

PAN # : AODPJ8147A

Present Address : No 29, Poosari Thoppu Street,

Munichalai Road

City : Madurai State : Tamil Nadu

Country : India Pin Code : 625009

Telephone # : 919535194395

Permanent Address : No 29, Poosari Thoppu Street,

Munichalai Road

City : Madurai State : Tamil Nadu

Country : India Pin Code : 625009

Telephone # : 919535194395

Mobile # : 919535194395 E-mail ID : jaikumarth.net@gmail.com

Service Bond Details :

Expected Annual Gross Salary : Indian Rupee 600000 Tentative Joining Date : 15/12/2010
ACADEMIC QUALIFICATIONS :

Degree/Diploma Specialisation Institute Name From To Year of Passing % of Course Awards and
Marks Type Scholarships

Bachelor Degree BACHELOR OF ELECTRICAL & ANNA UNIVERSITY - MADRAS 18/07/2002 15/04/2006 2006 70 Full time
ENGINEERING ELECTRONICS
ENGINEERING

12th/Pre.Univ HIGHER SECONDARY PHYSICS & MATHS HSC 14/06/2001 13/05/2002 2002 80.1 Full time
EDUCATION

10th/SSC SSC Maths, Science SSLC 14/06/1999 18/05/2000 2000 89.8 Full time

Break in Study (Reason and Duration) :

Break between Study & Employment (Reason and Duration) :

EMPLOYMENT DETAILS : Work Experience : 35 Months

Name of Employer Address of Employer From To Designation Nature of Duties Monthly Gross Yearly Gross
Salary Salary

InterCall Bangalore 21/10/2009 27/11/2010 Software Engineer Developing asp.net Indian Rupee Indian Rupee
applications 20166 241992

Angel Broking Limited Mumbai 16/04/2009 28/09/2009 Web Developer Developing asp.net Indian Rupee Indian Rupee
applications 10100 121200

Mindssoft Technology Madurai 05/12/2007 28/03/2009 Web Developer Developing asp.net Indian Rupee 4000 Indian Rupee
applications 48000

Sutherland Global Services Chennai 05/10/2006 17/08/2007 Technical Support Executive Providing hardware and Indian Rupee Indian Rupee
network support 19567 234804

Break During Employment (Reason and Duration) : Did asp.net course in NIIT / 3 Months, 0 Years
Languages Known (Mother Tongue appearing first) :

Language Speak Read Write

Tamil Yes Yes Yes

Hindi No Yes Yes

English Yes Yes Yes

Relatives in TCS

Name Employee # Location Relationship

Rajasekaran N 385829 Pune Friend

REFERENCE DETAILS :

Reference 1 Reference 2

Name Madhusudhanam Reddy Rajasekaran

Full Address Bangalore Pune

Contact Number 919438958038 918600925247

Designation Software Engineer Software Engineer

Organization InterCall TCS

Known since 2 Months, 1 Years 9 Months, 8 Years

Nature of acquaintance experience experience

Details of earlier appearance in TCS Test/Interview :

DECLARATION :

I certify that the information furnished above is factually correct and subject to verification by TCS (including Reference Check & Background Verification). I accept that an
appointment given to me on this basis can be revoked and/ or terminated without any notice at any time in future if any information has been false, misleading or deliberately
omitted/suppressed. I also certify that I am at present in sound mental and physical condition to undertake employment with TCS.

Bangalore 27/11/2010

(Place) (Signature) (Date)