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    Restricted: Fill Out All Blanks and Checkboxes Completely. Counter-Sign Any Type of Erasure

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    charlene mae
    This document is a background verification consent form that contains personal information and authorizes an organization to perform background checks. It requests information such as name, date of birth, addresses, contact details, identification documents, education history, criminal record, and employment history. The applicant also declares that they authorize the collection and verification of the information provided and releases all entities providing information from liability.

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    Restricted: Fill Out All Blanks and Checkboxes Completely. Counter-Sign Any Type of Erasure

    Uploaded by

    charlene mae
    39 views6 pages
    This document is a background verification consent form that contains personal information and authorizes an organization to perform background checks. It requests information such as name, date of birth, addresses, contact details, identification documents, education history, criminal record, and employment history. The applicant also declares that they authorize the collection and verification of the information provided and releases all entities providing information from liability.

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    This document is a background verification consent form that contains personal information and authorizes an organization to perform background checks. It requests information such as name, date of birth, addresses, contact details, identification documents, education history, criminal record, and employment history. The applicant also declares that they authorize the collection and verification of the information provided and releases all entities providing information from liability.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    39 views6 pages

    Restricted: Fill Out All Blanks and Checkboxes Completely. Counter-Sign Any Type of Erasure

    Uploaded by

    charlene mae
    This document is a background verification consent form that contains personal information and authorizes an organization to perform background checks. It requests information such as name, date of birth, addresses, contact details, identification documents, education history, criminal record, and employment history. The applicant also declares that they authorize the collection and verification of the information provided and releases all entities providing information from liability.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    Fill out all blanks and checkboxes completely.

    Restricted Background Verification Consent Form


    Counter-sign any type of erasure.
    Background Verification Consent Form/
    Date Accomplished (05/07/2021) /
    √
    Name Cortez, Charlene Mae Bautista

    Last Name First Name Middle Name

    Signature_______________________________________________
    Provide all other and previous full name/s used (e.g. maiden name, aliases, etc.)
    (1)

    Date ______________________________
    Last Name First Name Middle Name

    (2)
    Last Name First Name Middle Name

    (3)
    Last Name First Name Middle Name

    Civil Status Single √


    Married
    Country of Citizenship________________________ City _______________State/ Region _______________

    Printed Name__________________________________________________
    Country of Birth _____________________________ City _______________State/ Region _______________ Permanet
    Country of Residence ________________________________________
    Current Address

    House No., Street Name

    Barangay Town/City Zip

    Permanent Address  Same as Current Address


    House No., Street Name

    Barangay Town/City Zip

    Phone numbers Landline Mobile


    Other contact numbers Email Address_______________________

    Identification. Present at least one of the following and provide a photocopy. ID must have a photo. Enricle the type of ID presented

    Social Security Passport Voter's ID Senior Citizen Seaman's Book / OFW ID PRC
    Driver's License Postal ID GSIS ID ACR POEA/ OWWA Cert IBP ID

    Do you have a passport issued by the Philippines?  Yes  No


    Have you been issued a passport by another country?  Yes √ No
    If yes, please provide the following information:
    Passport Number ___________________________________
    Place of issue ___________________ Issuance date: _________________ Expiration date: __________________
    Do you have dual or multiple citizenship?  Yes √ No
    If yes, please provide the following information:
    Country _________________________ Country Identification Number _________________________
    List all visas that have been issued to you
    _________________________________________________none___________________________________________________

    Have you ever been convicted of a criminal offense?  Yes  No√


    If yes, please explain the charges: (Use an additional sheet of paper if necessary)

    What city, country and year did the convictions occur?

    Education
    Name and Location of School Years Attended Degree
    Primary

    High School

    College/ Vocational Education

    Graduate, Post Graduate


    Revised v2.0 TELUS International Philippines Page 1 of 2 July 2014 Fill out all blanks and checkboxes completely. Restricted Background
    Verification Consent Form
    Counter-sign any type of erasure.
    I hereby authorize TELUS International Philippines to perform a background verification as it pertains to employment, which may include, but
    is not limited to: identity verification, criminal records check, experience, employment and academic verification; and background and
    reference checks. I understand that any false or misleading information given in this application, interviews, correspondence or discussions,
    may result in rejection of my application; and in the event of employment, may result in termination.

    Printed Name

    Signature Date

    Revised v2.0 TELUS International Philippines Page 2 of 2 July 2014


    Declaration: I _____________________________________ hereby authorize < Telus International
    Philippines, Inc. > or any of its affiliates, and any persons or organizations acting on its behalf to verify
    information presented in my employment application and to procure an employment report or an investigative
    report for that purpose. I understand that such a report may contain information about my background,
    character and personal reputation. I further understand and agree that, in the event of my employment, an
    employment report or investigative report may be procured in connection with subsequent employment
    decisions. I also voluntarily authorize MAQResearch Inc. to perform reference checks of my employment and
    such other checks and inquiries as are necessary in order to verify information provided by me in my
    employment application. I hereby release from liability all persons or entities requesting or supplying such
    information. Moreover, I understand that my employment with the Firm may be terminated with immediate
    effect should any information provided herein be proven untrue.

    _____________________________ _________________

    Signature (SGD) Original Date


    XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
    XXXXXXXXXXXXXXXX
    Date: __________________________________

    Office of the Registrar


    _______________________________________________
    _______________________________________________

    Gentlemen:

    This is with regards to my application for employment with <


    __________________________________________ >
    I respectfully request the following information to be verified and certified if possible in behalf of its Verification
    Company.

    1.Full Name: ____________________________________________________

    2.Course/s ____________________________________________________
    3.Date of ____________________________________________________
    Graduation
    4.Inclusive ____________________________________________________
    Date of
    Attendance

    Looking forward to your continuous support and guidance.

    Very truly yours,


    ____________________________________________
    Full Name and Signature
    (For female applicant, kindly specify your Maiden Name)

    MAQResearch Inc. respects data subjects and operates in compliance with applicable laws on Data
    Privacy Protection and Data Security, specifically, the Data Privacy Act of 2012 (“R.A. 10173”) of the
    Republic of the Philippines. This Data Privacy and Protection Policy reinforces compliance with the
    national law and it’s implementing rules and regulations.

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