sinnoig Personal Information -ersonal Information osPi Print this Page *Note for Korean Residents/Citizens: In accordance to the Korean Personal Information Protection Act (PIPA), First Advantage is restricted from obtaining Korean Resi REGISTRATION NUMBER IN THIS FORM. lent Registration Numbers. DO NOT PROVIDE YOUR KOREAN RESIDENT Tile First Name* Miadle Name st Name* Rafael Renz ivilar (Deyao Date of Birth Day Month Year 14+) January 7 | 1997 + \dentification Type identification #* Father's Name lother’s Maiden Name INBI Clearance (Do0oARNZ78-161179958| Roque Caharop Dayo RRequel Abella Villar Handphone Number Home Phone Number Office Phone Number Country Country Area Country Area Code” Phone No. Code” Code Phone No. Code Code Phone No. (+63 | (9950192913, Email 10* (dayaorafaelrenz@omail.co (Current Adcress* 'B11 Lt Celina Plains Subdivision PhS, Bray. Labas, ‘Sta. Rosa City, Laguna reviousAdéress1* '826 L33 Legian Imus Il, Bray. Carsadang Bago, [mus City, Cavite PreviousAdéress2* '410 Tenement Bidg., Bray. Western Bicutan, Taguig icity $$ reviousAdéress3* Na reviousAddress4* Na PreviousAdcresss* NA Education Educational Check institution Attended Please list down all your previous addresses within the last 10 years Hukou Adéress (For People's Republic of China Citizen only or with PRC ID. nter NA if Not Applicable)" INA ‘San Pedro College of B htpsesp adv com/cdeireportPreview.do?action=repartPreviow 19sinnoig spi Did you take this course through distance learning?* yes © No ountry* Philippines Dates Attended (From)* Dates Attended (To)* Day Month Year Day Month Year 1 ¥) June (2015 7) 31 ¥ | May y 2019 ¥ alificatlon Attained™ ‘Bachelor of Science in Accountancy GA, — Greduatec* © Yes No Date of Graduation Day Month Year 25. ¥ June 2019 ¥ Professional Qualification Do you have Professional Licenses/Qualification?* yes © No ‘Self Declaration Check Self Declaration 4. Have you ever been convicted in a court of law and/or administrative tribunal of any country, or subject of any investigation ‘concerning criminal offenses?* Yes ® No 2, Have you ever been accused/charged or found guilty of an offence in any administrative or disciplinary proceeding?™ Yes ® No 3. Has your employment ever been terminated by an employer? Yes ® No 4. Have you ever been asked to resign?” Yes © No 5. Have you ever been suspended or dismissed by an employer for cause?* Yes © No htpsesp adv com/cdeireportPreview.do?action=repartPreviowsinnoig spi 6. Have you ever filed a case against any of your previous employer?™ Yes © No 7. Have you ever been refused entry to a foreign country?* Yes © No 8, Have you ever been or are you currently unable to fulfil any of your financial obligations, in any jurisdiction?* yes ® No 9, Have you ever been or are you currently subject to a judament debt which is unsatisfied, either in whole or in part, in any Jurseletion?™ Yes ® No nee 10, Have you ever been declared a bankrupt/Insolvent in any jurisdic Yes ® No 111. Are you subject to any restrictive covenant, or any other restrictions, with respect to your employment with Citigroup? Yes ©) No 412. Do you have any directorships or shareholdings held in any entty including any corporation, sole proprietor or partnership? yes © No 13, Have you ever taken illegal and/or habit forming drugs, narcotics, chemicals or have you ever been treated for @ drug addiction?* Yes © No 14. Have you ever been previously in a permanent position, or contract or temporary position via third party, by any company entity thin the Cit Group of Companies (e.g. Citibank, Solomon Smith Berney, Diners Club, etc)?* Yes ® No % thereby certifythat all the declared information abave are true and complete and I understand that any omission of misrepresentation related to such declarations may result to refusal of employment or immediate dismissal.* htpsesp adv com/cdeireportPreview.do?action=repartPreviow a9