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Background Check Form

This document is a background check form containing sections for an employee's personal information and an acknowledgment and consent section. The employee agrees to undergo a background investigation to confirm their identity, qualifications, and fitness for employment. The employee consents to the company collecting, using, and processing their personal information according to the company's privacy statement. The employee also declares that all information provided is true and accurate.

Uploaded by

Jheallaine Andrea dela Peña-Chua
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© © All Rights Reserved
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2K views1 page

Background Check Form

This document is a background check form containing sections for an employee's personal information and an acknowledgment and consent section. The employee agrees to undergo a background investigation to confirm their identity, qualifications, and fitness for employment. The employee consents to the company collecting, using, and processing their personal information according to the company's privacy statement. The employee also declares that all information provided is true and accurate.

Uploaded by

Jheallaine Andrea dela Peña-Chua
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Annex E

BACKGROUND CHECK FORM

EMPLOYEE PERSONAL INFORMATION

NAME
_____________________________________________________________________________
(Last Name) (First Name) (Middle Name)

PRESENT
ADDRESS

PERMANENT
ADDRESS

DATE OF BIRTH
CITIZENSHIP

ACKNOWLEDGMENT AND CONSENT

By signing below and submitting this form, I understand and agree that, as part of the employment
selection and onboarding process, I shall undergo a background investigation commissioned by Everise
(the “Company”) to confirm my identity and validate my stated qualifications and fitness for employment
with the Company. The investigation shall cover inquiry of identity, financial records and criminal records
check.

I hereby agree for the Company to collect, use, transfer and other process personal information about me
consistent with the Privacy Statement found in Annex C of the Job Offer Letter. I also acknowledge that
under the Philippine Data Privacy Act of 2012 and other privacy regulations , some personal information
can be collected, transferred or disclosed without my consent and that the Company reserves the right to
undertake such activity, when appropriate. To the extent that I have provided (or will provide) personal
information to the Company about dependents or family members, I certify that I have obtained their
consent to the use (including transfer and disclosure) of their personal information consistent with these
statements, and for any individuals not legally competent to give consent, I consent on their behalf and
confirm that I have authority to do so.

I further declare that all information provided in this form are true to the best of my knowledge and that
any false or malicious information in this form or in my application documents, or any omission which is
misleading will be sufficient grounds for revocation of or termination from employment upon discovery.

SIGNATURE: DATE:

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