Candidate Declaration Form

In accordance with Northern Trust's policy on employment of ex-offenders, we may restrict employment
of individuals who have been convicted of a criminal offense , therefore it is necessary for us to be
informed of certain records you may have.

Notice to all candidates: You are not required to disclose sealed/expunged/spent records of conviction
or arrest. Answering 'yes' will not necessarily bar you from employment.

Factors such as recency of the offence, seriousness and nature of the violation, and rehabilitation will be
taken into account.

*1. Have you ever been convicted of a crime other than for a minor traffic offence?
No Yes

Note: Any offence involving the operation of a motor vehicle while impaired by or under the influence of
drugs or alcohol is NOT considered a minor traffic offence.

If yes, please indicate the date, city and state the offence occurred in and provide an explanation of
the incident.

REQUIRED DOCUMENTS
Please provide the following documents to your recruiter for the purpose of background checks:

1) Photo - One passport sized photograph of yourself

2) Education
a) 10th Mark Sheet
b) 12th / PUC / Diploma Mark Sheet
c) Graduation Mark Sheets (all semesters / years)
d) Graduation / Convocation or Provisional Degree Certificate
e) Post-Graduation Mark Sheets (all semesters / years) If applicable
f) Post-Graduation / Convocation or Provisional Certificate If applicable
3) Identity Proofs
a) PAN Card or Acknowledgement copy of the application
b) Any government ID proof such as valid Passport Copy, Drivers License, Aadhar Card OR
Voters ID
4) Address Proofs
a) Any government address proof such as valid Passport Copy, Drivers License, Aadhar
Card OR Voters ID
b) Electricity Bill or Rental Agreement
5) Previous Employment - for each employment referenced in the application form:
a) Appointment Letter of current company
b) Last 3 months Salary Slip of current company
c) Relieving Letter of previous 2 companies

NTAC:3NS-20
ACKNOWLEDGEMENT

Northern Trust, as referenced in this application, is intended to refer to The Northern Trust Company
and its affiliates.
I understand that I must provide satisfactory documentation of my authorization to work in
India as a condition of employment with Northern Trust.
Northern Trust is an Equal Opportunity Employer. Hiring and employment decisions are made
without regard to race, color, religion, sex, national origin, age, disability, citizenship, veteran
status, or any other characteristic protected by law.
I agree to provide copies of all relevant certificates and documents requested.
I understand and agree that any employment or offer of employment is subject to receipt of
satisfactory references concerning employment and educational history, a satisfactory
background check and submission of required documents for personnel records.
I understand that convictions for various crimes may restrict my eligibility for employment.
I understand that if I am aware of any medical issue which may interfere with my ability to
complete this process or with the performance of my duties, I should make my recruiter aware
of this.
I certify that the information furnished on this application and during the application process is
true, complete and correct and understand that I am liable for inaccuracies and omissions.
I understand and agree that any misstatement, misrepresentation, or omission of fact on this
form or on a resume will constitute grounds for refusal to hire, rescission of an offer of
employment, or disciplinary action up to and including termination, regardless of when such
misstatement, misrepresentation, or omission is discovered.
I authorize Northern Trust and its representative, now and during my employment, to
authenticate information I have provided in my CV/resume and this form, including but not
limited to academic, residential, achievement, job performance, attendance, litigation, personal
history, credit reports, driving records, and criminal history information. Additionally, I authorize
all who may have information relevant to this enquiry to disclose it to Northern Trust and /or its
representative. I release all concerned from any liability on account of such disclosures.

I HAVE READ, I UNDERSTAND, AND I AGREE TO THE ABOVE.

Full Name:

Signature:

Date:

NTAC:3NS-20