Private & Confidential

PERSONAL INFORMATION FORM (PIF)
It is the policy of Citibank Singapore Limited, Citibank, N.A. and any of its holding companies, associate companies, branches, subsidiaries, representative offices, affiliates and agents (together, “Citigroup”, and each a “Citigroup entity”) to conduct background checks on all candidates commencing work with Citigroup. As detailed in your offer letter, your employment is subject to the successful completion of our background screening process and verification of information about your background. This process requires the hiring Citigroup entity as set out in your offer letter (the “Bank”) to obtain references about you from past employers and, in certain cases, regulatory authorities, academic and professional bodies. Please answer ALL questions completely and honestly Please provide information even if you believe we already have it. Information previously provided may be checked against information provided in this form. The deliberate or reckless provision of misleading or false information or omission of material information may affect your employment with the Bank. If a question is not applicable to you, please mark “N.A.” in the space provided. All questions which are applicable must be answered. Should there be insufficient space for your answers, please attach annex(es) which should be identified as such and signed by the signatory to this form.

IMPORTANT NOTES
The following supporting documents are required to be attached with the completion of this Personal Information Form (PIF). 1 Pay Slip (from most recent employer) a. If your pay slip is not available, please provide alternate documentation (bank statement, salary increment letter or tax bill/statement) as available. 2 Bonus Slip (from most recent employer) a. If your bonus slip is not available, please provide alternate documentation (bank statement or tax bill/statement) as available. 3 Tertiary Scroll/Educational and Professional Certificate/ Marks Sheet/ Results of applicable Capital Markets and Financial Services Examinations (where relevant) Please provide a copy of your tertiary scroll/educational and professional certificate/ marks sheet/ results of applicable Capital Markets and Financial Services Examination, where relevant, for verification. 4 CPF Statements for Self Employed Periods For Singaporeans who have been previously self-employed, please provide a copy of your CPF statements for the period involved. For foreigners, please provide a copy of your tax documents for the period involved. Please provide detailed reason(s) if you have NOT provided any of the documents requested above. Yes No

I did not have any full-time jobs before so I do not have pay slip or bonus slip.

Note: In the event that we are not able to verify any of your previous employments, educational qualification and professional qualifications/licenses, you will be requested to provide the following:    Employment service certificate indicating period of employment and job title. Alternatively, if this is not available, documents such as offer letter, exit letter and business card can be provided. Copy of your educational certificates Copy of your professional qualifications/licenses

NTQ Initials …………………
SGPIF v2, Updated 1 Mar 2012 Page 1 of 11

Thai Script. Please underline SURNAME Nationality NRIC/FIN Number Occupation Name of Employer Emergency Contact Details Name (underline Surname) Date of Birth Passport Number Relationship Contact Number(s) NGUYEN VAN DAT Father +84983375600 NTQ Initials ………………… SGPIF v2.com FOR SINGAPOREAN PERMANENT RESIDENT (‘PR’) OR NON SINGAPOREAN Status: U.g.A Viet Nam Completed Not Applicable If exempted. Japanese Kanji etc). Full Name (as reflected in your National ID or Passport) Please underline SURNAME NGUYEN TRAN QUAN Maiden Name (if applicable) Gender Country of Birth National Identity Number Marital Status Race National Service Status Other / Previous Names (if applicable) Male Viet Nam 01/03/1992 Single Vietnamese Date of Birth Nationality Passport Number Religion Country of Citizenship Exempted 01/03/1992 Vietnamese B4056034 N. Please provide your name in local characters in “Other/Previous Names” if applicable (e. please provide reason for exemption: Contact Details Telephone Email Address 81792696 Mobile Number 81792696 nguyentranquan1992@gmail.Private & Confidential SECTION 1 – PERSONAL INFORMATION Please provide your name in FULL (as per your National Identity Card/Passport) and any aliases/alternative names if applicable.S. Updated 1 Mar 2012 Page 2 of 11 . you need to complete the attached CPF form. Korean/Chinese Characters. Green Card Holder/U. Citizen (Please fill up FICA form) Employment Pass/S Pass Holder Permanent Resident Work Permit Holder PR Number: Issue Date: Expiry Date: If you are a Permanent Resident and have been a PR for less than 2 years. Spouse Information Full Name of Spouse (as reflected in their National ID or Passport).S.

A N. Postal Code.Private & Confidential SECTION 1 – PERSONAL INFORMATION (continued) Please provide your Other/Local National Identity Number if you have lived or worked in the United States. previous and alternate addresses during the past TEN YEARS indicating clearly the Street Name/Number. United States SSN Canadian SIN N. please provide details below: Citigroup Entity/Business Unit From (mm/yy) /Location Yes To (mm/yy) No Last Position Reason for Leaving References (Please provide 2 work-related referees) Name Relationship & Number of Years Known Contact Number Occupation Email Referral Source Advertisement / Client Referral / Campus Recruitment / Employment Agency / Executive Search / Former Employee / Unsolicited Employee Referral (Name of Citibanker) ____________________________________________ Others: _________________________________ Referral Source (Please encircle) NTQ Initials ………………… SGPIF v2. Blk 2. Thailand. commencing with your current residence. the People’s Republic of China or Taiwan within the last TEN YEARS.A Other National ID Work / Visa / FIN Number N. Malaysia.A Were you conducting any financial advisory activities under the Securities and Futures Act of Singapore and/or the Financial Advisers Act of Singapore? Yes No If your answer is Yes.A N. please provide your Representative Number (if any): Residential Address (es) Please provide details of your current. 1 2 3 4 5 21 Prince Gerge Park. Rm F Citi group Related Information Have you ever been employed by a Citigroup entity? If your answer is Yes. Korea. Canada. Lv 7. Country. Updated 1 Mar 2012 Page 3 of 11 . State & City.

Only completed/attained/conferred tertiary qualifications and those tertiary courses which you are currently undertaking (with the intention to complete) should be included in the tables above. you should not include such a course. SECTION 3 – PROFESSIONAL INFORMATION Professional Qualifications / Licenses – Attained Institution Qualification / Membership Address Date of Qualification ID # / Membership # (if applicable) Telephone d d m m y y y y NTQ Initials ………………… SGPIF v2. Updated 1 Mar 2012 Page 4 of 11 . where relevant. Viet Nam Was this an External / Long-Distance course? Other Qualification – Yet to be Attained / Conferred / Currently Pursuing Please state qualification yet to be attained/conferred / currently pursuing. Institution Name Qualification Name Type of Qualification Date of Graduation Dates of Study (From) Address of Institution Was this an External / Long-Distance course? Masters d d d d m m m m y y y y y y Degree y y Diploma Certificate Student / Roll Number Dates of Study (To) Telephone Number d d m m y y y y Yes No NOTE: If you have previously undertaken a tertiary course which you did not complete and which you do not intend to complete. for verification. Tertiary Scroll/Educational and Professional Certificate/ Marks Sheet/ Results of applicable Capital Markets and Financial Services Examinations (where relevant) Please provide a copy of your tertiary scroll/educational and professional certificate/ marks sheet/ results of applicable Capital Markets and Financial Services Examination.Private & Confidential SECTION 2 – EDUCATIONAL INFORMATION Highest Qualification – Attained / Conferred Please state highest tertiary qualification attained/conferred. Institution Name Qualification Name Type of Qualification Date of Graduation Dates of Study (From) Address of Institution Yes No d 0 d 0 Hung Vuong High School for the Gifted High School Certificate Masters Degree y 2 y 0 y 0 y 1 y 0 y 0 Diploma Certificate 1 d d 1 m 0 m 0 7 Student / Roll Number Dates of Study (To) Telephone Number m 2 9 7 y 0 d 1 d 0 m 7 m y 0 2 y y 1 y 0 Gia Lai.

Annual Wage Supplement share options. do not round off figures) Annual Basic Salary Currency Amount (Exclude bonus. addresses and. Previous employers will be contacted to verify your employment history. allowances. Please provide a copy of your last drawn full month pay slip and evidences of actual bonus received (from your most recent employer). VP etc) Reason for Leaving Voluntary Involuntary Telephone Number Last Functional Title (Business Mgr etc) Direct Supervisor’s Name Immediately or Not until d d m m y y y y Remuneration Received For the CURRENT Financial Year (Exclude future or expected income. Central Provident Fund. over time. Updated 1 Mar 2012 Page 5 of 11 . Details of any period of unemployment. super annuation. Do not use initials or abbreviations. other fixed & variable income) Currency Amount Permanent Position / internship Consultant / Self Employed From From d d d d d m m m m m m y y y y y y y y y Y Y y To To To d d d d d d m m m m m m y y y y y y y y y y y y Temporary / Contracting (provide details From d below) Agency Branch Address Contact Name Telephone NTQ Initials ………………… SGPIF v2. other fixed income) Annual Bonuses (Declare only last bonus received & not expected bonus. where possible. allowances. etc within the last SEVEN YEARS or (TEN YEARS if your rank is Managing Director and above) should be provided. Current or Most Recent Employer (1) Please indicate if we may contact your current employer Employer Name Address Department/Branch Last Corporate Title (MD. self employment. career breaks. you will be required to provide evidence of actual receipt of any bonus declared) Currency Amount Annual Allowances (Includes share options. the telephone number of each employer.Private & Confidential Professional Qualifications / Licenses – Attained Institution Qualification / Membership Address Date of Qualification ID # / Membership # (if applicable) Telephone d d m m y y y y SECTION 4 – EMPLOYMENT INFORMATION Employment History Please provide details of all previous employment over the last SEVEN YEARS (or TEN YEARS if your rank is Managing Director and above) in descending order beginning from the most recent employment. Please provide full names.

Updated 1 Mar 2012 Page 6 of 11 . VP etc) Reason for Leaving Permanent Position / internship Consultant / Self Employed Voluntary Involuntary From From d d d d d m m m Telephone Number Last Functional Title (Business Mgr etc) Direct Supervisor’s Name m m m y y y y y y y y y Y Y y To To To d d d d d d m m m m m m y y y y y y y y y y y y Temporary / Contracting (provide details From d below) Agency Branch Address Contact Name Telephone Employment Gaps (Please provide details of your activities for all gap periods between Employer 2 & 3) From (mm/yy) To (mm/yy) Details Previous Employer (3) Employer Name Address Department/Branch Last Corporate Title (MD. VP etc) Reason for Leaving Permanent Position / internship Consultant / Self Employed Voluntary Involuntary From From d d d d m m Telephone Number Last Functional Title (Business Mgr etc) Direct Supervisor’s Name m m y y y y y y Y Y To To d d d d m m m m y y y y y y y y NTQ Initials ………………… SGPIF v2.Private & Confidential SECTION 4 – EMPLOYMENT INFORMATION (continued) Employment Gaps (Please provide details of your activities for all gap periods between Employer 1 & 2) From (mm/yy) To (mm/yy) Details Previous Employer (2) Employer Name Address Department/Branch Last Corporate Title (MD.

Updated 1 Mar 2012 Page 7 of 11 . VP etc) Reason for Leaving Permanent Position / internship Consultant / Self Employed Voluntary Involuntary From From d d d d d m m m Telephone Number Last Functional Title (Business Mgr etc) Direct Supervisor’s Name m m m y y y y y y y y y Y Y y To To To d d d d d d m m m m m m y y y y y y y y y y y y Temporary / Contracting (provide details From d below) Agency Branch Address Contact Name Telephone Employment Gaps (Please provide details of your activities for all gap periods between Employer 4 & 5) From (mm/yy) To (mm/yy) Details Previous Employer (5) Employer Name Address Department/Branch Last Corporate Title (MD.Private & Confidential SECTION 4 – EMPLOYMENT INFORMATION (continued) Temporary / Contracting (provide details From d below) Agency Branch Address d m m y y y y To d d m m y y y y Contact Name Telephone Employment Gaps (Please provide details of your activities for all gap periods between Employer 3 & 4) From (mm/yy) To (mm/yy) Details Previous Employer (4) Employer Name Address Department/Branch Last Corporate Title (MD. VP etc) Reason for Leaving Permanent Position / internship Consultant / Self Employed Voluntary Involuntary From From d d d d m m Telephone Number Last Functional Title (Business Mgr etc) Direct Supervisor’s Name m m y y y y y y Y Y To To d d d d m m m m y y y y y y y y NTQ Initials ………………… SGPIF v2.

either in whole or in part. 3. with respect to your employment with Citigroup? Have you ever been suspended or dismissed by an employer? Do you have any directorships or shareholdings held in any entity. sole proprietor or partnership? Have you ever taken narcotics. any habit forming drugs or have you ever been treated for a drug addiction? Yes No Question Number Details – for all questions answered ‘Yes’ NTQ Initials ………………… SGPIF v2. 5. 8. 6. in any jurisdiction? Have you ever been or are you currently subject to a judgment debt which is unsatisfied. 7. Question Have you ever been refused entry to a foreign country? Have you ever been convicted in a court of law of any country? Have you ever been or are you currently unable to fulfill any of your financial obligations. 2.Private & Confidential SECTION 4 – EMPLOYMENT INFORMATION (continued) Temporary / Contracting (provide details From d below) Agency Branch Address d m m y y y y To d d m m y y y y Contact Name Telephone Employment Gaps (Please provide details of your activities for all gap periods between Employer 5 & 6 ) From (mm/yy) To (mm/yy) Details SECTION 5 – SELF-DECLARATIONS Please answer ALL the questions and provide details at the end of the section for all questions answered “Yes”. S/N 1. in any jurisdiction? Have you ever been declared a bankrupt in any jurisdiction? Are you subject to any restrictive covenant. 9. or any other restrictions. including any corporation. Updated 1 Mar 2012 Page 8 of 11 . 4.

the conducting of reference checks with any of my previous employer(s) and any pre-employment security screening. in the event of my employment with the Bank. for any of the purposes mentioned in paragraph 3 above. I acknowledge that any reports or checks obtained pursuant to the foregoing may contain information about my background. service providers or contractors or merchants. 4 Class of Transferees: I agree that my personal data may be disclosed to the staff member(s) / employee(s) of Citigroup or such outside organization or agent as authorized by Citigroup from time to time to process personal data of Citigroup’s employees. including the obtaining of any credit bureau information report and investigative report. Updated 1 Mar 2012 Page 9 of 11 . detection and prosecution and to comply with obligations imposed by law. In connection with the foregoing. then my employment with the Bank may be terminated with immediate effect should any information provided herein be proven untrue. I agree that any personal data provided by me or on my behalf to Citigroup from time to time prior to or in the course of my employment with Citigroup (if employment is subsequently offered to me) as well as all other personal data related to me collected and held by Citigroup upon applying for any service or products from Citigroup will be used by Citigroup for legitimate purposes which include without limitation workforce relations and human resources administration. prevention. collection agencies. business administration and operation management. internal or external auditors. Purpose of Collection: Without prejudice to the foregoing. 3. disseminate or use my personal data in manner that causes it to be transferred or accessed from computer systems owned or operated by or on behalf of Citigroup throughout its global computer network. 2. I further understand and agree that. True and Accurate statements and/or information: To the best of my knowledge. information security and technology services. internal or external consultants or internal or external legal adviser of Citigroup. physical security and safety. any financial institutions. an employment report or investigative report relating to me may be procured by the Bank in connection with such employment. INFORMATION AND/OR DATA PROVIDED 1. agents. credit reference agencies. at any time. character and personal reputation. obtain and verify any information relating to me as set out in this personal information form or such other documents as provided by me. within as well as outside Singapore as considered appropriate. correct. complete and I make them freely without any reservations. any party giving or proposing to give a guarantee or third party security to guarantee or secure my obligations.Private & Confidential SECTION 6 – DECLARATION AND AUTHORISATION REGARDING STATEMENTS. charge or credit card issuing companies. store. I understand that if I am employed by the Bank. Signature: Full Name (as reflected in your national ID or passport): Date of Birth (dd/mm/yy): Identity Card Number (NRIC/FIN/Passport): Signature Date: (dd/mm/yy) NGUYEN TRAN QUAN 01/03/1992 B4056034 07/05/2012 NTQ Initials ………………… SGPIF v2. I acknowledge and agree that Citigroup maintains computer systems in data centers and at other locations in the United States of America and in various countries throughout the world and that Citigroup may collect. Authorization to verify information: I hereby authorize the Bank and any third party selected by the Bank to. the statements and/or information that I have provided above are true. I authorize the disclosure of any of my personal information from the Bank to and between any other entity of Citigroup or to any third party selected by any of them. process. any other person who has established or proposes to establish any business relationship with Citigroup or recipient of such data.

and to conduct reference checks and other enquiries regarding my background. Updated 1 Mar 2012 Page 10 of 11 . Signature: Full Name (as reflected in your national ID or passport): Date of Birth (dd/mm/yy): Identity Card Number (NRIC/FIN/Passport): Signature Date: (dd/mm/yy) NGUYEN TRAN QUAN 01/03/1992 B4056034 07/05/2012 NTQ Initials ………………… SGPIF v2. I am willing that a photocopy of this authorization be accepted with the same authority as the original. character and personal reputation.Private & Confidential AUTHORIZATION TO FIRST ADVANTAGE I hereby authorize First Advantage to verify information provided in my resume and personal information form. I release all such persons from liability on account of such disclosure to First Advantage. I authorize all persons who may have information relevant to First Advantage’s enquiries to disclose it to First Advantage.

I agree to hold CBS harmless.A. Singapore Branch.A. for and/or in respect of all or any loss or damage arising from the disclosure of my credit information as requested. Signature: Full Name (as reflected in your National ID or Passport): Date of Birth (dd/mm/yy): Identity Card Number (NRIC/FIN/Passport): Postal Code: Signature Date: (dd/mm/yy) NGUYEN TRAN QUAN 01/03/1992 B4056034 118430 07/05/2012 NTQ Initials ………………… SGPIF v2.Private & Confidential AUTHORIZATION TO CREDIT BUREAU (SINGAPORE) I have applied to Citibank N. Updated 1 Mar 2012 . Singapore Branch and/or its related company(ies) for employment and in connection thereto hereby authorize Credit Bureau (Singapore) (CBS) to release my credit reports to Citibank N.

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