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CONSENT FORM

AUTHORISATION FOR RELEASE OF INFORMATION FOR BACKGROUND VERIFICATION PURPOSES


I __________________ Son/Daughter of ________________________________________________ hereby understand and acknowledge that Millowsatya Services Private Limited (hereinafter referred as Millowsatya) shall be rendering verification services to the Requestor as offered in the user agreement. The services to be rendered by the Millowsatya shall include package, as selected by the requestor, while placing the order on the website and I have been explained about such services proposed to be undertaken by the requestor. The purpose of this express and willful consent is well explained to me in the language known to me by the Requestor and I hereby fully authorize the Millowsatya to hold access and use the Verification Data in perpetuity to perform its services as it deems necessary.
I hereby authorize Millowsatya and its designated agents and representatives to conduct a comprehensive review of my background and to provide a report to the Requestor for my employment (present/past), financial, commercial, matrimonial, criminal, drug history and professional background verification, may or may not include additional information, depending upon the package selected and number of checks to be undertaken, by the Millowsatya on the request of Requestor, including but not limited to tenure, employment, remuneration, education, address, marital, professional, financial, commercial, creditworthiness or any other information obtained from past employers/suggested references/any other sources as may be deemed fit, to whom I may or may not have provided any consent to share such information / Feedback with Millowsatya etc.
I understand and agree that Millowsatya is relying on the information provided to it by my past employers / relevant sources and is not responsible or liable for accuracy or completeness of the information provided to it from such sources.
I understand and confirm that Millowsatya may share its feedback/verification report(s) with the Requestor or otherwise for a fee, upon receipt of my information/details through this consent/authorization by electronic message or otherwise; and that the Millowsatya may retain the information contained in the said feedback/verification report and any update thereto without any restrictions, reservation or expiration. I also understand and agree that Millowsatya may use my information/details to review and analyze market trends or other research and study work and prepare a database, publish the same and for any other business purpose as may be deemed fit by the Millowsatya.
I understand that my information/details may be collected, stored, retained or processed anywhere in the world and not necessarily within the jurisdiction of the country where I currently reside, or where I was or am temporarily located, and have no objection for the same.
I confirm that when I share my information with Requestor, it is solely at my discretion and that I have satisfied myself of the credentials of the Requestor, as provided by the Requestor, and take complete responsibility of the same and I am fully and completely responsible for permitting my employer /references/sources (present/past) to share the information with the Millowsatya and for authorizing Requestor to request and obtain my feedback/report from the Millowsatya. I recognize and acknowledge that the accuracy, validity or completeness of the feedback/report provided by Millowsatya is not guaranteed and I hereby release Millowsatya and its parent, sister, affiliated companies, successors and assigns and its and their directors, officers, agents, employees and independent contractors (collectively, ”Millowsatya’s Affiliates”) from any liability for any negligence in connection with the preparation of the Report and from any loss, damages, expenses, costs or obligations of any kind and nature whatsoever suffered by me resulting directly or indirectly from the inaccuracy, invalidity or incompleteness of the Report. I understand and confirm that the Millowsatya’s Affiliates are not responsible for any losses which I may incur or any damages which may arise as a result of the feedback/verification report carried out by the Millowsatya on the basis of my information/details either provided by me directly or through any third person as my Requestor or by any person illegally representing as my Requestor or for permitting my former or current employer to share the information with Millowsatya or my information not being correct.
I hereby authorize the complete release of these records or data pertaining to me which an individual, company, firm, corporation, or public agency may have. I authorize the full release of the information described above, without any reservation, through all the details to do my Background Verification. I hereby release Millowsatya and its agents, officials, representatives, or assigned agencies, including officers, employees, or related personnel both individually and collectively, from any and all liability for damage s of whatever kind, which may at any time, result to me, my heirs, family or associates because of compliance with this authorization and request to relapse. I certify that all information provided below and attached document is correct to the best of my knowledge. Any false statements provided in this form and attached document will be considered just cause for the termination of employment at any time. This authorization and consent shall be valid in original, fax, or copy form. The following information is required by law enforcement agencies and other entities for identification purposes and the same will be in 0nicra’s database for future marketing & promotion purposes. I further agree, consent and accept that terms of this form has been well explained to me by the requestor, in language know to me, and I have understood the same and hereby executing this consent voluntarily thereto.
Applicant Name :
Signature :
ID (Driving License/Aadhaar/PAN Card) :
Current Address :
City Postal Code :
Phone :

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