Employment Application Form

Form No: HR – 101(A)
(Revised on 23.08.17)
REF No:
(A Muthoot M George enterprise)

Corporate Office: Muthoot Chambers, Opp. Saritha Recent Passport
TheatreComplex size Photograph
Banerji Road, Kochi – 682 018 (Not more than six
months old)
APPLICATION FOR EMPLOYMENT
Please fill up the application in your own hand writing in block letters. Fill all the columns applicable. Attach
copy of CV and attested copies of testimonials / certificates in support of information given in this form.
Post applied for:

Name (in block letters as mentioned in Aadhaar card):
Age : Date of birth: Place of birth:

Nationality: Religion: Caste/ Denomination: Sex:
Marital Status: Married / Single/Widowed No: of Children:
Height: Weight:
Identification marks: Blood Group:
If Scheduled caste/ Back ward / Tribe please specify:
Aadhaar No: (copy to be attached)
PAN Card No: (copy to be attached)

Identity Card No. [Voters ID / Driving License /Passport ] :
(Tick the appropriate item & copy to be attached)
Father’s Name: Occupation:
Mother’s Name: Occupation:
copy to be /Wife’s
Husband’s attached)
Name: Occupation:
Permanent address:
District: State: PIN:

Tel No with STD Code:
Present address:
District: State: PIN:

Tel. No with STD Code: Mob No: E-mail:
Languages Known Speak (Y/N) Read(Y/N) Write(Y/N)

1. EDUCATION (Begin with School Leaving):
Month % Name of College / Name of Board/

Examination & Year Marks Institution University Main subjects studied
1. Academic
2. Professional
2. PROFESSIONAL / SPECIALISED / TRAINING:

Period
Name of Training: Place of Training Stipend drawn From To
3. MEMBERSHIP OF PROFESSIONAL / SOCIAL/ CULTURAL BODIES
Name of the Organisation Name of your association
4. SPORTS AND EXTRA CURRICULAR ACTIVITIES
Give details of the position of responsibility held and your participation in other activities in your University / District/
State/ National Level :
EMPLOYMENT HISTORY (Begin with present employer. Engagement after completing qualifying Examination to be recorded)
Name & Period of
service Gross Salary Annual CTC
Address of No. of Reason
Description of duties (*excluding (*excluding
Employers Designation Employees for
From To (in brief) variable variable
previously worked supervised Leaving
(Date) (Date) components) components)
with
*Variable components including variable incentive, withdrawable allowance, re-imbursement, travelling allowance etc.
1. Are you a pensioner? (Yes/No)If ‘yes’ what is the monthly rate of pension you draw? Rs. /……………………….
(Copy of pension documents to be attached)
2. Mention the name of Bank and Account No. from which you draw the pension:
Reference (other than relations):
Name Occupation, Address and Telephone No
What salary and perquisites do you expect?(Rs.)

May we refer to your previous employers? Yes / No
How soon could you be free to take - up new appointment, if selected?
Indicate the source through which you came to know about the vacancy:-
(News paper Advt/ Career portal/ Recruitment agency/ Other reference)
Whether any of your friends working with Muthoot Group / Any other Muthoot family Group. If ‘Yes’, please
provide the following details:
Name of the Group :
Name of the employee: Division /Branch:
Particulars of family members / close relatives (if any) working with Muthoot Finance / Other Muthoot Institutions /
Other NBFCs:
Name of Relative :
Name of the Company &its branch : Position Held :
Period of Service: From……………………………………………To…………………………………………….
Specify Nature of Relationship :
(Spouse/Father/Mother/Son/Daughter/Son-in-law/Daughter-in-law/Brother/Sister/Brother-in-law/Sister-in-law/Nephew/Niece/Co-
brother/Co- sister/Uncle/Aunt/Cousin/Father-in-law/Mother-in-law/Step Father/Step Mother/Grand Children/Grand Parents)
Have you ever been an accused in any criminal cases? (Yes/No) If 'Yes' furnish details:
Have you ever been suspended/ Punished/dismissed by any of your previous Employers? (Yes/No) If 'Yes' furnish
details:
Declaration:
I certify that the statements made by me in answer to the foregoing questions are true, complete and correct to the
best of my knowledge and belief. I understand that any misrepresentation or material omission / suppression of
facts made in this application or any other document furnished to the company renders a staff liable to termination
or dismissal, without notice. I hereby give my consent for retrieving my CIBIL report as part of recruitment
formalities in order to assess my liabilities at any point of time as decided by the company.
Date: Signature of Applicant

For office use only
Remarks: Date of Interview:
If selected:
Salary offered Allowances Total :
Designation Dept. Posted :
Proposed date of joining
Interview Board Members
Name & Signature

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Form No: HR – 101(A)

(A Muthoot M George enterprise)

Post applied for:

Age : Date of birth: Place of birth:

PAN Card No: (copy to be attached)

District: State: PIN:

District: State: PIN:

Languages Known Speak (Y/N) Read(Y/N) Write(Y/N)

Month % Name of College / Name of Board/

2. PROFESSIONAL / SPECIALISED / TRAINING:

3. MEMBERSHIP OF PROFESSIONAL / SOCIAL/ CULTURAL BODIES

Name of the Organisation Name of your association

4. SPORTS AND EXTRA CURRICULAR ACTIVITIES

What salary and perquisites do you expect?(Rs.)

Date: Signature of Applicant

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