8exleyheath

C8 Securlty (UK) Llmlted

PO 8ox 263
Kent
DA7 9DQ
Phone: 077l8 587 485
Pax: 020 8303 0089
www.cbsecurlty.co.uk
EXPLANATION OF SECURITY SCREENING

To ensure that you provide us with the correct information, please read the following notes carefully.

As I am sure you are aware, Security Screening can be made difficult by lack of information or incorrect
information being provided on the application form.

Here are some simple guidelines for you to follow that will enable the screening to progress as swiftly as
possible.

Carry out a simple check of the information you have provided prior to sending the application form to us. In
particular:


Completeness of addresses and postcodes

Full company name, telephone, fax number and email address

Two character referees with type of relationship and dates of association (no less than 2 years)

Gaps in employment history - the month of joining one employment should be the same month, or
the month following the month of leaving the last employment

The Letter of Authorisation must be completed and sent with the Application Form

Provide evidence of attendance at an education Institute i.e. certificates

Provide copies of employment references or any proof of employment

Indicate if employed via an Employment Agency and provide contact details

Print Form Submlt by Lmall
INTRODUCTION. As you may well be aware, we have to carry out security screening on you to ensure that you are
not a present or potential future security risk. The British Standard which we must comply with in doing so is BS
7858:2006. Security Screening is necessary for the job that you have applied for, and the sooner we can get your
screening completed the sooner we can all relax and get on with the job in hand.

Under the guidelines laid down by BS 7858, you are required to provide evidence of previous employers, periods of
self- employment, periods of unemployment, periods spent in full-time education, periods spent abroad and periods
spent in prison. The purpose of this is to verify your whereabouts on a month-by-month basis for the last 5 years. It is
also necessary to verify your name and address and take up two Character References. This must all be completed
within 10 weeks. Please complete the attached Application form fully and accurately and submit to CB Security (UK)
Limited as soon as possible. This will provide enough information for your screening to proceed without delay. You
also need to sign the enclosed Letter of Authority to authorise CB Security (UK) Ltd to take up your references.

YOUR HELP IS APPRECIATED You can assist greatly in your security screening by ensuring that your application
form contains all of the relevant information. Please use this list as a tick-off list. If there is any information, which you
do not have, submit the application form without it, but please let us know when we can expect to receive it.

NAMES AND ADDRESSES Please ensure that all names and addresses are accurate. Provide postcodes and
telephone numbers including area codes. Provide the full and accurate name of the company or school to which you
refer. Ensure that surnames are spelt correctly and all information is clearly written and legible.

CHARACTER REFERENCES Should be two people that have known you on a month-by-month basis for at least two
years out of the most recent five. Please state their relationship with you, and ask their permission before putting
them on the application form. Neither referee should be related to you or, be someone with whom you are in a
long-term romantic relationship, nor should they reside at the same address as you.

PREVIOUS EMPLOYERS State who your immediate superior was or who the person was to whom you were
responsible. State also your job title at the time of leaving and your reason for leaving. Ensure all dates are recorded
as month and year both for starting and for leaving employment with a company.

NO LONGER TRADING Previous employers who are no longer trading can present a problem. Provide as much
detail as you can about the company and CB Security (UK) Ltd will figure out what to do. If you are still in touch with
someone from that period or you know their whereabouts please submit their details as an additional character
reference.

PERIODS OF SELF-EMPLOYMENT Should be accompanied by details of your professional advisers (Accountants,
Solicitors, Bankers) during that period. Additionally, provide a letter instructing them to release details of your claims
to CB Security (UK) Ltd.

PERIODS OF UNEMPLOYMENT Should be accompanied by details of the office at which you were claiming the
benefit. Additionally, you must provide a letter requesting confirmation of the dates that benefits were claimed. A copy
of the letter must be retained by CB Security (UK) Ltd.

PERIODS OF FULL-TIME EDUCATION Should be accompanied by accurate dates of courses. This should state the
month and the year of the start and finish of the course, back to the date of leaving secondary education.

PERIODS SPENT ABROAD Should be accompanied by a Visa, Passport Stamp, Hotel bills, Wage slips (if working
abroad), Credit Card Statements, etc, to show that you were where you said you were during this period. You may
wish to send this directly to CB Security (UK) Ltd by Recorded Delivery or you may wish to await them contacting you
for this information.

PERIODS SPENT IN PRISON Should be accompanied by exact dates on a month-by-month basis. Accurate
addresses of prisons are important including any prisoner reference number. If you have a Certificate of Discharge or
similar please submit with the application form.

MaIe FemaIe
Yes No
Address:
Town:
County:
Post Code:
mpIoyment AppIication
Surname:
Plrst:
Moblle:
Lmall:
Home Tel:
Surname at 8lrth:
Place of 8lrth:
Passport Number:
Lductlon Plnlsh Date: Date of |ssue:
Llcence Number:
Other Type: Posltlon applled for:
No. of Dependants:
Date of blrth:
N| Number: Date:
Driving Licence:
Type:
Tltle:
Natlonallty:
Country of 8lrth:
Lthnlc Group:
Marltal Status:
Peglstered Dlsabled:
All sections must be completed. Dates must be entered in day-month-year dd-MM-yyyy
format or selected from the calendar. Enter N/A where not applicable.
ProfiIe (PIease incIude any information tbat may assist witb your appIication)
SIA Licence Number Lic. exp date
Visa 7ype eg student Visa No.
Issue date xpiry date
Conditions of issue
Mr
|ndlan
|ndla
Slngle
|ndlan
Provlslonal
l68 A west Hendon 8road way
London
London Hendon
London Mlddlesex
Nw97AA
Mohammed
07780437225
lateef.azamQgmall.com
Hasnaln Azam Slddlqul
07780437225
Mohammed
|ndla Hyderabad AP,
G7040879
l2 Dec 20l2
Door Supervlsor
l8/07l985
SK 65 64 24 A 7 1ul 20l2
0l30 0l3l l727 4627 04/06/20l3
work Permlt PC8043374
27/0l/20l2 28/l2/20l3
NO condltlon Plght to work Pull tlme
mpIoyment DetaiI: Address: Reference DetaiIs: mpIoyer DetaiIs:
Pax:
` Name:
Tel:
Contact: Address:
1ob Tltle:
Moblle:
Lmall:
Town:
County:
Post Code:
` Prom:
` To:
Salary:
Posltlon:
Peason for leavlng:
Dtber DetaiIs:
our name lf dlfferent:
Llst the [obs you held, dutles performed, skllls used or learned, advancements, or promotlons whlle you worked at thls company:
1.
mpIoyment DetaiI: Address: Reference DetaiIs: mpIoyer DetaiIs:
Pax:
` Name:
Tel:
Contact: Address:
1ob Tltle:
Moblle:
Lmall:
Town:
County:
Post Code:
` Prom:
` To:
Salary:
Posltlon:
Peason for leavlng:
Dtber DetaiIs:
our name lf dlfferent:
Llst the [obs you held, dutles performed, skllls used or learned, advancements, or promotlons whlle you worked at thls company:
2.
mpIoyment DetaiI: Address: Reference DetaiIs: mpIoyer DetaiIs:
Pax:
` Name:
Tel:
Contact: Address:
1ob Tltle:
Moblle:
Lmall:
Town:
County:
Post Code:
` Prom:
` To:
Salary:
Posltlon:
Peason for leavlng:
Dtber DetaiIs:
our name lf dlfferent:
Llst the [obs you held, dutles performed, skllls used or learned, advancements, or promotlons whlle you worked at thls company:
3.
mpIoyment DetaiI: Address: Reference DetaiIs: mpIoyer DetaiIs:
Pax:
` Name:
Tel:
Contact: Address:
1ob Tltle:
Moblle:
Lmall:
Town:
County:
Post Code:
` Prom:
` To:
Salary:
Posltlon:
Peason for leavlng:
Dtber DetaiIs:
our name lf dlfferent:
Llst the [obs you held, dutles performed, skllls used or learned, advancements, or promotlons whlle you worked at thls company:
4.
mpIoyment History
SAPL SK|LLS LTD AM|P 06/20l0
7 1un 20l2
8AS|C M|N|MUM wAGL
0793964ll06
ll2
AUDLL POAD
LONDON
LONDON HLNDON
Nw4
0793964ll06
amlrsbradmanQyahoo.com
MANAGLP
wAS |N PULL T|ML LDUCAT|ON
mpIoyment DetaiI: Address: Reference DetaiIs: mpIoyer DetaiIs:
Pax:
` Name:
Tel:
Contact: Address:
1ob Tltle:
Moblle:
Lmall:
Town:
County:
Post Code:
` Prom:
` To:
Salary:
Posltlon:
Peason for leavlng:
Dtber DetaiIs:
our name lf dlfferent:
5.
mpIoyment DetaiI: Address: Reference DetaiIs: mpIoyer DetaiIs:
Pax:
` Name:
Tel:
Contact: Address:
1ob Tltle:
Moblle:
Lmall:
Town:
County:
Post Code:
` Prom:
` To:
Salary:
Posltlon:
Peason for leavlng:
Dtber DetaiIs:
our name lf dlfferent:
6.
Wben were you unempIoyed: Address: UnempIoyment DetaiIs:
` Agency Name: Address:
Town: Post Code:
` Prom:
` To: our name at tlme:
1.
Wben were you unempIoyed: Address: UnempIoyment DetaiIs:
` Agency Name: Address:
Town: Post Code:
` Prom:
` To: our name at tlme:
2.
How Iong bave you known tbem: Address: Reference DetaiIs:
Tel:
` Contact: Address:
Moblle: Lmall: Town:
County:
Post Code:
` Slnce:
1.
How Iong bave you known tbem: Address: Reference DetaiIs:
Tel:
` Contact: Address:
Moblle: Lmall: Town:
County:
Post Code:
` Slnce:
2.
Cbaracter References
Periods of UnempIoyment
mpIoyment History Continued
Wben were you unempIoyed: Address: UnempIoyment DetaiIs:
` Agency Name: Address:
Town: Post Code:
` Prom:
` To: our name at tlme:
3.
MP NAwAZ l 1an 2007
02082024644
2ll HLNDON
8POAD wA
LONDON
LONDON
Nw97DL
077354l4462 azzlmohdQyahoo.co.uk
MO|Z l 1an 2007 655 8 North Clrcular Poad
Neasden London
London
Nw27A
0754l77629l daulatkhan57Qyahoo.co.ln
Address: Reference DetaiIs: Institute DetaiIs:
Pax:
` Name:
Tel:
Contact: Address:
Posltlon:
Town:
County:
Post Code:
our name lf dlfferent:
LeveI: e.g. MCS Subject: Crade: Date Dbtained: xamination oard:
Dtber uaIifications
Address: Reference DetaiIs: Institute DetaiIs:
Pax:
` Name:
Tel:
Contact: Address:
Posltlon:
Town:
County:
Post Code:
our name lf dlfferent:
LeveI: e.g. MCS Subject: Crade: Date Dbtained: xamination oard:
Attendance DetaiIs: Address: Reference DetaiIs: Secondary ScbooI/CoIIege DetaiIs:
Pax:
Tel:
Contact: Address:
Posltlon: Town:
County: Post Code:
` Prom:
` To:
our name lf dlfferent:
LeveI: e.g. CCS Subject: Crade: Date Dbtained: xamination oard:
` Name:
ducation
Attendance DetaiIs: Address: Reference DetaiIs: University/CoIIege DetaiIs:
Pax:
` Name:
Tel:
Contact: Address:
Posltlon: Town:
County: Post Code:
` Prom:
` To:
our name lf dlfferent:
LeveI: e.g. Sc Subject: Crade: Date Dbtained: xamination oard:
Furtber ducation
GOvLPMLNT SCHOOL HDLPA8AD ANwLP l 1an l999 moghalpura road GOvT hlgh
HDLPA8ADHDLPA8AD HLAD MASTLP
|NTLPMLD|ATL COMMLPCL LCONOM|CS C|v|CS lST D|v|S|ON 8OAPD OP |NTLPMLD|ATL |ND|A 03/03/2003-03/2005
COMMLPCL LCONOM|CS C|v|CS |NTLPMLD|ATL |ST D|v|S|ON 8OAPD OP |NTLPMLD|ATL |ND|A 03/03/2003-03/2005
l 1an 2003
OSMAN|A UN|vLPS|T LAXM|KANT l 1an 2005
040-27098048
Osmanla Unlverslty. Hyderabad
HDLPA8AD
HD AP 500057
HLAD O P THL COMMLPCL DLPAPTMLNT
LLvLL 7 Advance Dlploma |n 8uslness Management ACH|vLD LDLXCLL 06/l0/2008 - 06/06/20l0
GLNLPAL M8A M8A SUNDLPLAND UN|vLPS|T ACH|vLD l2/07/20l0- 09/l2/20l2
8 Sep 2008
.

How Iong bave you Iived tbere: Address:
` Address:
County:
Town:
Post Code:
` Prom:
1.
` To:
How Iong bave you Iived tbere: Address:
` Address:
County:
Town
Post Code:
` Prom:
2.
` To:
ResidentiaI History (Last five years)
How Iong bave you Iived tbere: Address:
` Address:
County:
Town:
Post Code:
` Prom:
4.
` To:
DOCUMENT CHECKLIST

The following documents are required to enable applications to be processed quickly.

Contract (signed and all pages initialled)

Vetting Form (Fully completed)

Signed Letter of Authorisation

Four Passport-sized Photographs

Copy of Passport

Copy of Visa (If applicable or, a copy of correspondence from UK Home Office Immigration
and Nationality Directorate)

Copy of Criminal Records Bureau (CRB) Disclosure

Copy of Security Industry Authority (SIA) Licence

Letter of Incorporation if Limited Company or Payroll Company details

Copies of Security Training Certificates

2 Forms of Proof of Address (Bank or Credit Card Statement and a Utility
Bill)

Copy of Driving Licence
Proof of National Insurance number i.e copy of NI card or P45


l 1an 2009 l68 A west Hendon 8road
Mlddlesex
London
Nw27AA T|LL NOw
l 1an l990 8-l4-24/l M|PALAM TANK
HD AP
HDLPA8AD
50052

L77R DF AU7HDRISA7IDN

PIease read tbis carefuIIy before signing tbis appIication form

| __________________________________________ (Appllcant's full name) understand that
employment wlth the Company ls sub[ect to satlsfactory references and securlty screenlng ln
accordance wlth 8S 7858.

| undertake to cooperate wlth the Company ln provldlng any addltlonal lnformatlon requlred to
meet these crlterla,

| authorlse the Company and/or lts nomlnated agent to approach prevlous employers, schools/
colleges, character referees or Government Agencles to verlfy that the lnformatlon | have provlded
ls correct,

| authorlse the Company to make a consumer lnformatlon search wlth a credlt reference agency,
whlch wlll keep a record of that search and may share that lnformatlon wlth other credlt reference
agencles.

| understand that some of the lnformatlon | have provlded ln thls appllcatlon wlll be held on a
computer and some or all wlll be held ln manual records.

| consent to the Company's reasonable processlng of any sensltlve personal lnformatlon obtalned
for the purposes of establlshlng my medlcal condltlon and future fltness to perform my dutles. |
accept that | may be requlred to undergo a medlcal examlnatlon where requested by the
Company. Sub[ect to the Access to Medlcal Pecords Act l988, | consent to the results of such
examlnatlons to be glven to the Company. | understand and agree that lf so requlred | wlll make a
Statutory Declaratlon ln accordance wlth the provlslons of the Statutory Declaratlons Act l835, ln
conflrmatlon of prevlous employment or unemployment

| hereby certlfy that, to the best of my knowledge, the detalls | have glven ln thls appllcatlon form
are complete and correct.

| understand that any false statement or omlsslon to the Company or lts representatlves may
render me llable to dlsmlssal wlthout notlce.


Slgned ________________________________ Dated _________________________________