Type of Investigation Date of Report

(Background Investigation)
SCOPE: PBI CBI CLASSIFICATION:
CONFIDENTIAL
IDENTIFYING DATA
SUBJECT: NATIONALITY STATUS

Occupation: DOB: POB:

HOME ADDRESS:
CONTROL DATA
FILE NR: 1 INVESTIGATING UNIT: CONTROL OFFICE:
Intel Operative 5SFBN, SFR(A) PA
INVESTIGATION DATA
AUTHORITY: BASIS OF INVESTIGATION:
a. STL from OG2, 1ID, PA dated 10
August 2021. Candidate Soldier Applicant
b. AFPRG-200-053; and
c. Basic CI task
PERIOD OF INVESTIGATION
Date Started: Date Completed:
Put (/) if the subject is qualified and (x) if the subject is not qualified
Checklist Yes No Source/Remarks
Educational Background Tesda NC-II (SMAW)
Local Agency Check (LAC) No Derogatory Record
PSA Record Check
General Reputation (Neighborhood Check) Qualified
Has negative feedback from previous Unit Qualified
User of prohibited drugs Qualified
Subject/Family involved in illegal activities Qualified
Subject/Family involved in dubious/threat Qualified
organizations
Attended the schools/indicated in PHS/Resume Qualified
History of Mental Illness or Stress Qualified
With Negative Feedback from present co- Qualified
workers/peers
Other Findings: Subject is found to be of good moral character, no history of mental illness, not
connected/affiliated with any dubious/subversive organization and not using prohibited drugs.
BI conducted by: BI Reviewed by:

Jeffrey D Doropan JAYSON B TABABAN

Sgt (Inf) PA 1LT (INF) PA
Intelligence NCO Intelligence Officer