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INFORMATION ON PAST EMPLOYMENT AND ASSIGNMENTS RELATED TO GE

I, _____________________________________________ son of ____________________________,


resident of _______________________________________________________________________,
hereby declare as under:
1) Details of the GE Organizations I was employed with in the last 36 months:
Name of GE Organization
a. _______________________________
b. _______________________________

Country

From

To

__________
__________

__________
__________

______
______

2) Details of past association / engagement / assignment / projects for GE in the past 12 months
directly or indirectly in any form as:
a. Employee of GE
b. Employee of any GE GDC
c. Contractual / Vendor staff of GE
d. Contractual / Vendor staff of any GE GDC
e. Any other level of association with GE or GE GDC (please specify)
(please tick the appropriate and give brief detail about association with GE, below)
___________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
I hereby declare that the above is true to the best of my knowledge and I have hidden nothing related
to the above employment period. I authorize verification of the same by Birlasoft, GE or anybody
authorized by Birlasoft or GE. In the event of any of the information furnished by me above or in my
CV is found to be incorrect or untrue, I shall be held responsible for any and all consequences arising
thereof.

Signature of the Candidate / Employee : __________________________________________________


Name of the Candidate / Employee : _____________________________________________________
Date: _________________________

Place : _______________________________

Note : In this document, the word GE means all GE organizations, GE GDCs, Vendors and Contractors
of GE anywhere in the globe.

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