Hiring Supplemental / Personal Data Change Form

Select action New Hire Personal Data Change

New Hire

Please select... Clear Form

Country *
Please select... Create Ticket
Legal Entity*

Associate's Data (As Per Country National ID Card)

Title* Please select...
Associate First Name*
Associate Middle Name
Associate Last Name*
GDDB Id/ SAP Personnel Number * (Existing Associates)
Marital Status Please select...
Academic Title Please select...
Number of Children

Permanent Account Number

(PAN)
(See attached PAN copy) sadf
Nationality by Birth * Please select...
2nd Nationality / Current
Nationality Please select...
UAN Number
Aadhar card number*
Religion Please select...

Associate Address Data Permanent Address Mailing address Emergency address

Care of

Street and House Number*

Second Address Line
City*
District*
Post Code*
State/Region* Please select... Please select... Please select...
Country* Please select... Please select... Please select...
Contact No.
Tenure at address

Bank Details(Please provide cancelled cheque)

Account Holders Name (Payee)*
Bank Name/Key*
Bank Account Number*

Identification
IC Type (Passport/PAN/Driving License) Place of Issue
Date of Expiry
Identity Number (Passport / PAN No. / Driving License) (DD.MM.YYYY)

Issuing Date (DD.MM.YYYY) Country of Origin Please select...

Passport Details (* For Expats)

Passport Number*
Date Of Issue* (DD.MM.YYYY)
Valid to Date* (DD.MM.YYYY)
Place Of Issue*
Country Of Issue* Please select...

Family Members / Dependents Father * Mother *

Relation* Please select... Please select...
First/Middle Name*
Last Name*
Birth date* (DD.MM.YYYY)
Gender* Please select... Please select...

Spouse Child1
Relation* Please select... Please select...
First/Middle Name*
Last Name*
Birth date* (DD.MM.YYYY)
Gender* Please select... Please select...

Emergency Contact
Relation* Please select...

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 First/Middle Name*
Last Name*
Address*

Contact Number*

**Please provide details of all educational & professional qualification attained starting with your first qualification
Only degree/diploma equivalent qualifications or higher are to be provided
Please attach copies of marks sheets & degree certificates for all education & professional qualification details mentioned below:

Record # 1 (highest degree) Record # 2

Name of Degree* Please select... Please select...
Course Name (Please specify)
Education Type* Please select... Please select...
Educ. Institute Name*
Country* Please select... Please select...
City
Date Started* (DD.MM.YYYY)
Date of Completion* (DD.MM.YYYY)
ID/Roll Number

Record # 3 Record # 4
Degree Level* Please select... Please select...
Course Name (Please specify)
Education Type* Please select... Please select...
Educ. Institute Name*
Country* Please select... Please select...
City
Date Started* (DD.MM.YYYY)
Date of Completion* (DD.MM.YYYY)
ID/Roll Number

Work History

* *Please provide complete employment history prior to Novartis Group Companies

Ensure that you are descriptive wherever necessary; e.g. if the company has closed/ceased operations/moved location, do mention it
Employee Code/ ID/ Number of your previous employer is mandatory
Start with your most recent/current employer, followed by details of the employment preceding that

Record # 1 Record # 2
Employer*
Date from-to* (DD.MM.YYYY)
Position*
Functional* Please select... Please select...
City*
Country* Please select... Please select...
ID/Roll Number
If Temporary or Contractual, please provide name of agency
Reason for Leaving
Last Salary (CTC) Drawn / Current CTC
Details of Agency (if deployed from another agency / if
working on 3rd party
Name of Supervisor
Designation & Department of Supervisor
Supervisor's Contact No.
Supervisor's Email Id
Can a reference be taken now?
If 'No', please indicate date when reference can be taken

Record # 3 Record # 4
Employer*
Date from-to* (DD.MM.YYYY)
Position*
Functional* Please select... Please select...
City*
Country* Please select... Please select...
ID/Roll Number
If Temporary or Contractual, please provide name of agency
Reason for Leaving
Last Salary (CTC) Drawn / Current CTC
Details of Agency (if deployed from another agency / if
working on 3rd party
Name of Supervisor
Designation & Department of Supervisor
Supervisor's Contact No.
Supervisor's Email Id
Can a reference be taken now?
If 'No', please indicate date when reference can be taken

Please select (Yes/No) if the documents have been submitted for employment history:

Please select... Relieving Letter / Resignation Acceptance Resignation Acceptance

Please select... Service Certificate
Please select... Appointment Letter

452259914.xlsx 14/14
 Please select... Others (please specify)
Please select... None

Associate's Other Personal Data

Blood Group
Former / Maiden Names (if applicable)
Date(s) of Name Change
Languages Known (Pls. specify):
Speak
Read
Write

References

Reference 1 Reference 2
Name
Contact No.
Email Id
Occupation (Provide details)
Relationship with the Referee
Years you have known the Referee

Other Information
Are you currently engaged in any other business either as a proprietor, partner, officer, director, trustee, employee, agent, retainer, contractor, consultant,
free lancer or otherwise. If yes, please give details.

Please select... Details if Yes:

Have you ever been dismissed from the services of any previous employer(s)? If yes, please give details.

Please select... Details if Yes:

Have you ever been convicted in a court of law or of a criminal offence? If yes, please give details and status of prosecutions against you.

Please select... Details if Yes:

Have you ever had any civil judgments made against you? If yes, please give details.

Please select... Details if Yes:

Have you ever been employed with Novartis Group of Companies? If yes, please give details.

Please select... Details if Yes:

Do you have any of your relatives employed in Novartis Group of Companies? If yes, please give details.

Please select... Details if Yes:

References
Please provide details of 2 references that may be contacted to obtain feedback.
Ensure that the references provided are not friends, members of your family or are current employees of Novartis Group of Companies

Reference 1 Reference 2

452259914.xlsx 14/14
 Name
Contact No.
Email Id
Occupation (Provide details)

Relationship with the Referee

Years you have known the Referee

Comments

Requestor

Declaration: “I hereby declare that the information I have given is true and correct to the best of my knowledge. I understand that a misrepresentation or
omission of facts called for herein shall be sufficient cause for cancellation of consideration for employment or dismissal from the Company’s service if I
have been employed, without liability to the Company."
Associate Name
"I hereby authorize _________________________________________ Signature
(Company Name) and/or * to conduct verification of all statements
its agents its
contained in this record if I am considered for employment. I understand that my employment is subject to satisfactory background verification.”

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 Background Verification Details Form
Associate's Data (As Per Country National ID Card)
Title*
Associate First Name*
Associate Middle Name
Associate Last Name*
Nationality by Birth *
2nd Nationality / Current
Nationality
Aadhar card number*

Associate Address Data Permanent Address

Care of

Street and House Number*

Second Address Line
City*
District*
Post Code*
State/Region* Please select...
Country* Please select...
Contact No.
Tenure at address

Identification
IC Type (Passport/PAN/Driving License)

Identity Number (Passport / PAN No. / Driving License)

Issuing Date (DD.MM.YYYY)

Passport Details (* For Expats)

Passport Number*
Date Of Issue* (DD.MM.YYYY)
Valid to Date* (DD.MM.YYYY)
Place Of Issue*
Country Of Issue*

**Please provide details of all educational & professional qualification attained starting with your first qualification
Only degree/diploma equivalent qualifications or higher are to be provided
Please attach copies of marks sheets & degree certificates for all education & professional qualification details mentioned below:
Name of Degree*
Course Name (Please specify)
Education Type*
Educ. Institute Name*
Country*
City
Date Started* (DD.MM.YYYY)
Date of Completion* (DD.MM.YYYY)
ID/Roll Number

Degree Level*
Course Name (Please specify)
Education Type*
Educ. Institute Name*
Country*
City
Date Started* (DD.MM.YYYY)
Date of Completion* (DD.MM.YYYY)
ID/Roll Number

Work History

* *Please provide complete employment history prior to Novartis Group Companies

Ensure that you are descriptive wherever necessary; e.g. if the company has closed/ceased operations/moved location, do mention
Employee Code/ ID/ Number of your previous employer is mandatory
Start with your most recent/current employer, followed by details of the employment preceding that

Employer*
Date from-to* (DD.MM.YYYY)
Position*
Functional*
City*
Country*
ID/Roll Number
If Temporary or Contractual, please provide name of
agency
Reason for Leaving
Last Salary (CTC) Drawn / Current CTC
Details of Agency (if deployed from another agency / if
working on 3rd party
Name of Supervisor
Designation & Department of Supervisor
Supervisor's Contact No.
Supervisor's Email Id
Can a reference be taken now?
If 'No', please indicate date when reference can be taken

Employer*
Date from-to* (DD.MM.YYYY)
Position*
Functional*
City*
Country*
ID/Roll Number
If Temporary or Contractual, please provide name of
agency
Reason for Leaving
Last Salary (CTC) Drawn / Current CTC
Details of Agency (if deployed from another agency / if
working on 3rd party
Name of Supervisor
Designation & Department of Supervisor
Supervisor's Contact No.
Supervisor's Email Id
Can a reference be taken now?
If 'No', please indicate date when reference can be taken

Please select (Yes/No) if the documents have been submitted for employment history:

Please select... Relieving Letter / Resignation Acceptance Resignation Acceptance

Please select... Service Certificate
Please select... Appointment Letter
Please select... Others (please specify)
Please select... None

References

Name
Contact No.
Email Id
Occupation (Provide details)
Relationship with the Referee
Years you have known the Referee

Other Information
Are you currently engaged in any other business either as a proprietor, partner, officer, director, trustee, employe
free lancer or otherwise. If yes, please give details.

Please select...
Have you ever been dismissed from the services of any previous employer(s)? If yes, please give details.

Please select...

Have you ever been convicted in a court of law or of a criminal offence? If yes, please give details and status of p

Please select...

Have you ever had any civil judgments made against you? If yes, please give details.

Please select...

Have you ever been employed with Novartis Group of Companies? If yes, please give details.

Please select...

Do you have any of your relatives employed in Novartis Group of Companies? If yes, please give details.

Please select...
References
Please provide details of 2 references that may be contacted to obtain feedback.
Ensure that the references provided are not friends, members of your family or are current employees of Novartis Group

Name
Contact No.
Email Id
Occupation (Provide
details)
Relationship with the
Referee
Years you have known the Referee

Comments

Requestor

Declaration: “I hereby declare that the information I have given is true and correct to the best of my knowledg
or omission of facts called for herein shall be sufficient cause for cancellation of consideration for employment
service if I have been employed, without liability to the Company."
Associate Name
"I hereby authorize _________________________________________ (Company Name) and/or its agents to
contained in this record if I am considered for employment. I understand that my employment is subject to satis
und Verification Details Form

Please select...

Please select...

Please select...

Mailing address Emergency address

Please select... Please select...

Please select... Please select...

Place of Issue
Date of Expiry
(DD.MM.YYYY)

Country of Origin Please select...

Please select...

ained starting with your first qualification

ded
ation & professional qualification details mentioned below:
 Record # 1 (highest degree) Record # 2
Please select... Please select...

Please select... Please select...

Please select... Please select...

Record # 3 Record # 4
Please select... Please select...

Please select... Please select...

Please select... Please select...

Companies
pany has closed/ceased operations/moved location, do mention it
y
he employment preceding that

Record # 1 Record # 2

Please select... Please select...

Please select... Please select...

 Record # 3 Record # 4

Please select... Please select...

Please select... Please select...

mitted for employment history:

Resignation Acceptance Resignation Acceptance

e
er
pecify)

Reference 1 Reference 2

proprietor, partner, officer, director, trustee, employee, agent, retainer, contractor, consultant,

Details if Yes:
 ious employer(s)? If yes, please give details.

Details if Yes:

nal offence? If yes, please give details and status of prosecutions against you.

Details if Yes:

yes, please give details.

Details if Yes:

anies? If yes, please give details.

Details if Yes:

up of Companies? If yes, please give details.

Details if Yes:
obtain feedback.
your family or are current employees of Novartis Group of Companies

Reference 1 Reference 2

given is true and correct to the best of my knowledge. I understand that a misrepresentation
se for cancellation of consideration for employment or dismissal from the Company’s
mpany."

__________ (Company Name) Signature Dateof (DD.MM.YYYY)

and/or its agents to conduct verification all statements
I understand that my employment is subject to satisfactory background verification.”