PERSONAL INFORMATION Legal First Name \[) Legal Middle Name AS LA Legal Last Name KAN Former Name/Maiden Name Date of Name Change to Current / 4 Other Names/Aliases Used /\) ieee sine Kanart PAN Number @WOPKIZO8 Passport Number MFOSISS O Date of Passport Issue | /02 (20'S Place of Issue Kol CAT A Date of Passport Expiry OF /O3/ 202 5° If you have previously worked/studied in the US or another country, please provide Social Security Number or equivalent Are you legally author! 1d to work in India? \Y & © Will you now or in the future require sponsorship for employment visa status? ( O If yes, please give details ‘Are you 18 years of age or older? FS ‘Are you aware of any medical issue that would interfere with your being successful in the performance of your duties? N'0 If yes, please give details BACKGROUND WITH NORTHERN TRUST 1) Have you ever been an employee of Northern Trust, in any region? If No, SKIP #2. (VO 2) If yes, please give details (dates of employment, role, office). /\) A 3) Have you ever worked at Northern Trust as a temporary employee, consultant, contractor or seconde, or in any other capacity? If No, SKIP #4, 4) IF yes, please give details (dates of work, role, office) /)A\ 5) If you are currently working onsite at Northern Trust as a temporary worker, contractor, consultant or secondee, please provide your LAN ID (logon ID) - e.g. LM123. If not applicable (i,e., you are not NTAC:3NS-20currently working in any capacity at Northern Trust), please leave blank. DO NOT enter "N/A", "NA", "No", "TBD", or "Unknown", if this is not your actual LAN ID, 6) Are any of your family members currently working at Northern Trust? If No, SKIP #7, CONTACT DETAILS Home Telephone Number Work Telephone Number Mobie/call number FBS SLI2E2 Email Address 25 lam 91 © @ gmat |« Current Home Adéress Une 1 3 70/8 ee Current Home Address Line 2 Garr €¥q/rod ty Bangalore Landmare Aaa. Aehiance OCphanon ge State Katnerte Kor Pin/Zip/Postcode SEBBO 5 COOTL eee ae ponte Lagat Ah (woss Lak shat If rented, please provide your Landiord's name, address and contact telephone number TAMMEDR KRANUM 7259779893, Highest Educational Level ek at e ca casntuicof Managem Caren or Lat Bavcatnalnstne RD~ © VL Date From 2. 6 OF DateTo 2010 F ea Subject Major FIMCUO C Course Type & ee Degree/Diploma obiaineg 2 & CMON BP astere Division/Ciass/Resut ck Cla ss Student 10/Errolment Number k kot hada 20.0917 Sea Shovet ‘Address and Telephone Number of institution 2.» M0 pau utp ne fNT May we contact your current employer to take a reference?! © = aeostt ¥ "ROCESS T NG BCT Ro! Present Host Recent Employer Name 1S 22 F\- ee Start Date MOL 2- olovetn a End Dated st October 2-9 ole Type WSS001 aE ie en Permanent/Contract Tee NTAC:3NS-20Desiatoniod Tue ASSO cH ode Department/Division Name (YC ‘Annual Remuneration (CTC per annum) 2, ISO OO Employee 10/Code AS E4969} Employed at BAA) OrflL ORE = Company Adéress and Telephone Number Sat(4 lake Seehee-T. KKo| keds Reason for Leaving PERSONAL (oro TM ‘Supervisor/Manager Name (Cn OUR A& ROY Supervisor/Manager Job Tile 4 HV AG EK ~OFERATITONE Previous Emplover Name-Previous: Start Date 22nd cho ben 201% ‘End Date G+) Movsy Dow Designation/ib The Senso Cnalgs Role Type Foy cht cow tent Employee 10/Code Employed at Gant. 1\ ~ Reston for Leaving Per wonerh ~ Raed ly Chase 2 efor = eurgany Coney Ades a Telephone number gh Mos § Superisor/ManagerName- Neresen see Pe ‘Supervisor/Manager Job Title “Teams L- €ox. Supervisor/Manager Contact Detail (Email and Telephone) ot bate of sinh 21 Ovebex 19 NTAC:3NS-20