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Source:
SPOC:
Position Title:
Date:
Employee Information Sheet

Name: Mobile#:
Current Address: Landline:
Permanent Address: Email Address:
Date of Birth: Gender: SSS#:
Place of Birth: Religion Tin#:
Marital Status: Race: HDMF/Pagibig MID#:
Passport No.: Citizenship: PhilHealth#:

Spouse: Date of Birth

1st Child’s Name: Date of Birth:
2nd Child’s Name: Date of Birth:

Educational Background
School: Year Graduated: Contact Number:
Degree Address:

Employment Background (Last 5 Years Only)

Company: Date:
Address: Position:
Immediate Supervisor: Contact #:
Company: Date:
Address: Position:
Immediate Supervisor: Contact #:
Company: Date:
Address: Position:
Immediate Supervisor: Contact #:

Personal Reference
Name: Name: Name:
Contact#: Contact#: Contact#:

I hereby authorize and request any present or former employer, school, law enforcement agency, credit bureau, or references to furnish the bearer with
any, and all information in their possession regarding myself that may be relevant and as requested by bearer in connection with my current/proposed
employment in ING.

I further consent to the uploading into third party systems contracted and used by the company, compilation and/or reproduction into reports or
documents of all and any information discovered or received regarding myself (whether written or electronic format) with such reports or documents to
be provided and kept solely by and for ING reference and consideration only.

By signing this letter, I hereby confirm that I have voluntarily given my consent and that the authority and consent I have provided herein to shall remain
valid and effective for all inquiries of the same nature that may be requested by ING during the duration of my employment with them.

I further consent to the compilation and/or reproduction into reports or documents of all and any information discovered or received regarding myself
(whether written or electronic format) with such reports or documents to be provided and kept solely by and for ING reference and consideration only.

I am willing to have a photocopy of this authorization accepted with the same authority as the original.

I hereby release ING, its officers and employees from any and all liability and responsibility, damages and claims of any kind whatsoever
arising from or in connection the with the authority and consent I have provided in relation to their inquiries.

Signature over Printed Name and Date:

Additional Information

1. In your previous employment, have you ever been subject of any complaint or allegation of unethical conduct or illegal trading practice, or any legal
proceedings or disciplinary action? YES NO
2. Have you ever had judgment including findings in relation to fraud, misrepresentation, or dishonesty given against you in civil or criminal proceeding
in the Philippines or elsewhere? YES NO
3. Have you ever been declared a bankrupt or convicted of any offense other than a traffic offence in the Philippines or elsewhere or are there
proceedings now pending which may lead to such a conviction? YES NO
4. Do you have any unspent criminal convictions whether in the Philippines or elsewhere? YES NO
5. Have you ever received any cautions, reprimands or final warning in respect of any criminal offence whether in the Philippines of elsewhere?
YES NO
6. Have you ever been interrogated as a suspect or are you currently involved in a criminal proceeding with respect to any criminal offence or do you
expect to be involved in such proceedings, whether in the Philippines of elsewhere? YES NO
7. Do any conditions of current probation or parole prohibit you from completing the tasks of the job for which you are applying? YES NO ✔
8. Have you ever been disciplined or fined by any regulatory body or stock exchange in the Philippines or elsewhere? YES NO
9. Within the past 10 years, please confirm whether you have:
A) been or are unable to fulfill any of your financial obligations, whether in the Philippines or elsewhere? YES NO
B) entered into a compromise or scheme of arrangement with your creditors (including debt repayment scheme), or made an assignment for the
benefit of your creditors, being a compromise or scheme of arrangement or assignment that is still in operation, whether in the
Philippines or elsewhere? YES NO
10. Do you have any outside business activities or part time jobs? YES NO (If yes, please specify:_______________)
11. Are you aware, to the best of your knowledge, of any family member or related person* who is currently working in:
• ING Bank (in any location)? YES NO (If yes, please provide complete name and position: ___________________________)
• A government agency/body? YES NO (If yes, please provide complete name, relationship, position and institution’s name: _____________)
• A corporation/entity who is a client of ING Bank (in any location) Or
• A corporation/entity who is a vendor/supplier to ING? YES NO (If yes, please provide complete name and position: ______________________)
12. How did you acquire Filipino citizenship? Birth Reacquisition Naturalization Others (please specify)
NOTE: If you acquired your Filipino citizenship by reacquisition, naturalization, or other means, kindly provide a photocopy of official
government-issued documentation to that effect and bring the original for comparison.
13. Are you a citizen of any country other than the Philippines? YES NO
• If yes, what are the countries of which you are a citizen?
• How did you acquire said citizenship? Birth Marriage Naturalization Others (Please Specify)
• When did you become a citizen of such foreign country (ies)?
NOTE: Please provide proof of citizenship for all above countries, e.g. currently valid passport.
14) To the best of your knowledge, have you ever lost your Philippines citizenship? YES NO
• If yes, how? Have you reacquired your Filipino citizenship? When? Please provide proof of reacquisition of citizenship.
15) Have you ever been involved in procedures at an enterprise or legal entity as a director or supervisory board member, which procedures have led to
refusal or retraction of a permit? YES NO

______________________________________________________________________________________________________________________________
*If you have responded ‘Yes’ to any of the questions from 1 to 7, please provide details below:

Declaration:
I hereby declare that the particulars provided herein, including any attachments, are true to the best of my knowledge and I have not willfully
suppressed any material facts. I voluntarily give ING the right to make a thorough investigation of my pas employment and activities, agree to
co-operate in such investigation, and release from all liability or responsibility all persons, or corporations supplying such information. I understand
that any false answers or statements made by me in connection with my application for employment with ING, will be sufficient grounds for
immediate termination.
If Employment is obtained under this application, I agree to abide by all rules, regulation and policies of ING. I understand all records or information
That I many have access to are strictly confidential and should not be removed from the premises or disclosed to third parties without the
authorization from ING.

Person to be notified in case of emergency:

Name: Contact#:
Relationship: Blood Type:

Fullname/Signature (New Joiner) Date: