To:

HR Compliance
HR CDT
Sykes Asia Inc. Cebu

I, Mr./Ms./Mrs. Kisha Mhae Abaquita , of legal age, acknowledge and pledge that
all information I will declare below are true and active. I understand that any information
withheld or misrepresented by me, whether intentionally or otherwise will result to
appropriate actions which may lead to sanctions and/or termination of my
application/employment.

SSS No. (“To follow” if pending): to follow

PAGIBIG No. (“To follow” if pending): to follow

PHILHEALTH No. (“To follow” if pending): to follow

TIN (“To follow” if pending): to follow

All government numbers I have declared above are correct and true to the best of
my knowledge. I understand that, as part of my pre-employment requirements,
photocopies of the government documents asked for above (SSS, PAG-IBIG,
PhilHealth, and TIN) will be requested during the first week of my employment with
SYKES Cebu.

I have read and understood the terms of this agreement thoroughly before submission.

Printed Name Date Kisha Mhae Abaquita May 18, 2022

Signature Signature of HR Compliance

Please print all your answers legibly. Where the information required is not applicable to you, please place an N.A. on the space provided. Fill out this
form as accurately and as completely as possible. Information deliberately withheld will adversely affect your application.

PERSONAL INFORMATION
1. Surname, First name, Middle name
(If Married, kindly indicate your Maiden name)
2. Birth Date (mm/dd/yy)
3. Birthplace
4. SSS number (important)
5. Telephone numbers / Mobile numbers (give both)
 6. Current Residence Address
(pls. specify house number, street, barangay and give any landmark)

7. Complete Name of Landlord (If Renting)

8. Telephone / Mobile number of landlord (landline preferred)

For fresh gradUates and applicants who do not have work experience ONLY
Name of Professor/OJT Supervisor:
Name of School/Company:
Contact number of Professor/OJT Supervisor:
Email Address of Professor/OJT Supervisor:
EMPLOYMENT BACKGROUND 11. Have you ever been sanctioned for FRAUD or
(Indicate ALL companies you worked for in the Last 7 Years) DISHONESTY? ● If YES, please give details.

C. 1. Name of Company
A. 1. Name of Company (MOST RECENT / CURRENT HERE) 2. Please indicate ALL work experiences, whether
Company Address (Location / Branch)
contractual/formal/informal type of work, regardless of the stint (short or
long).
3. Telephone number of HR Failure to declare ANY employer may result to a negative report.
4. Last Position held
5. Date Hired (please indicate month and year)
6. Date of Separation (please indicate month and year)

7. Type of Separation:

8. Name of the Last Supervisor Termination Lay Off / Redundancy Failed Training
Resignation End of Contract
9. Contact number of the Last Supervisor
Others Please Specify:
10. Email Address of the Last Supervisor
11. Have you ever been sanctioned for FRAUD or
DISHONESTY? ● If YES, please give details.
B. 1. Name of Company

2. Company Address (Location / Branch)

3. Telephone number of HR
4. Date Hired (please indicate month and year)
5. Last Position held
6. Date of Separation (please indicate month and year)

7. Type of Separation:

8. Name of the Last Supervisor Termination Lay Off / Redundancy Failed Training
Resignation End of Contract
9. Contact number of the Last Supervisor Others Please Specify:
10. Email Address of the Last Supervisor

2. Company Address (Location / Branch)

3. Telephone number of HR 11. Have you ever been sanctioned for FRAUD or
4. Date Hired (please indicate month and year) DISHONESTY? ● If YES, please give details.

D. 1. Name of Company
5. Last Position held
2. Company Address (Location / Branch)
6. Date of Separation (please indicate month and year)
3. Telephone number of HR

7. Type of Separation: 4. Date Hired (please indicate month and year)

5. Last Position Held

8. Name of the Last Supervisor 6. Date of Separation (please indicate month and year)

9. Contact number of the Last Supervisor

10. Email Address of the Last Supervisor
 7. Type of Separation: Resignation End of Contract
Others Please Specify:

8. Name of the Last Supervisor

9. Contact number of the Last Supervisor
10. Email Address of the Last Supervisor
11. Have you ever been sanctioned for FRAUD or
DISHONESTY? ● If YES, please give details.

E. 1. Name of Company
2. Company Address (Location / Branch)
3. Telephone no. of HR
4. Date Hired (please indicate month and year)
5. Last Position Held
6. Date of Separation (please indicate month and year)
Termination Lay Off / Redundancy Failed Training
7. Type of Separation: Resignation End of Contract
Others Please Specify:

8. Name of the Last Supervisor

9. Contact number of the Last Supervisor
10. Email Address of the Last Supervisor

Termination Lay Off / Redundancy Failed Training

Resignation End of Contract
Others Please Specify:

Termination Lay Off / Redundancy Failed Training

11. Have you ever been sanctioned for FRAUD or

DISHONESTY? ● If YES, please give details.

I understand that, as part of my employment application, an investigation or verification of the information that I have placed on this form may be
required. Thus, I am giving my consent to carry out said investigation or verification to facilitate my employment application. Verification of this
information, however, is only a preliminary step to my employment but is not an assurance of my acceptance to Sykes Asia, Inc. IF THERE
ISN’T ENOUGH SPACE ON THE FORMS, kindly add a table/bullet of other employers you have had within the parameter
given in the email instead (with the same format and information above).

(Applicant Signature over printed Name)

Date:
Reviewed by:
(Recruitment Officer)
____________________
(Date)

____________________
(Name of School)

____________________
(School Address)

Attention: Office of the Registrar

Verification of Scholastic Records

Sir/Madame:

In connection with my application for employment with SYKES ASIA, INC. for the
position of , I request that SYKES ASIA, Inc. and its accredited investigation company,
be allowed to verify my scholastic records, particularly the following information:

a) Complete Name:
b) School:
c) Course/Program:
d) Highest Educational Attainment:
College Graduate
College Undergraduate (please specify year level): ________
Others. Please specify:

e) Month and Year Graduated:

My student number is __________

Hoping for your usual prompt action.

Thank you.

Very truly yours,

__________________________
(Signature Over Printed Name)
 OFAC Information Sheet

required are not applicable.

Fullname
Last Name First Name Middle Name Salutation
(Mr. / Ms. / Mrs.)

A.K.A (Also Known As) If there is any

Last Name First Name Middle Name Salutation
(Mr. / Ms. / Mrs.)

Current Home Address

Street Name Subdivision / Village Name
House/ Building Unit / Room No.

Barangay Name City / Municipality Zip Code

Permanent Home Address

Street Name Subdivision / Village Name
House/ Building Unit / Room No.

Barangay Name City / Municipality Zip Code

Social Security Number Date of Birth

e.g. 99-9999999-9 or (mm/dd/yyyy)
9999999999
 Do not attach this page to other documents. US Employer, BGI & SAS; Version 2007-March 14 Consumer Report /
Investigative Consumer Report
(Including Substance-Abuse Testing / Drug Testing)
Disclosure and Release of Information Authorization
Through this document, it is being disclosed to me and I understand that a Consumer Report or
Investigative Consumer Report prepared about me as part of my application for employment and/or
continued employment.
I authorize _ to procure a Consumer Report from Verifications, Inc., and I authorize Verifications, Inc., a US-based Safe Harbor Certified
Consumer Reporting Agency, and its agents, to retrieve necessary information and prepare such Consumer Report. I understand that a
Consumer Report may be prepared summarizing information from personnel files, educational institutions, government agencies,
companies, corporations, credit reporting agencies, law enforcement agencies at the international, federal, state or county level, relating
to my past activities. I authorize these entities to supply any and all information concerning my background. The information received
may include, but is not limited to, academic, residential, achievement, job performance, attendance, litigation, personal history, credit
reports, driving records, and criminal history records. If my prior employers and/or references are contacted, the report may include
information obtained through personal interviews regarding my character, general reputation, personal characteristics, and mode of
living. I understand and authorize that some or all of this information about me may be transmitted electronically and, when required,
may be transferred across international borders. I understand that supplemental forms and/or authorizations may be required to obtain
international information and that host-country and receiving country privacy laws will be observed if information is transferred across
international borders.
I understand substance-abuse testing/drug testing may be a requirement of the position for which I am applying, or the position I wish to
retain. I consent to this testing and understand I must pass the substance abuse test/drug test as a condition of employment or
continued employment. I hereby authorize any physician, laboratory, hospital or medical professional designated by the above named
company to conduct such testing and release the results to authorized representative/s of the above-named company and/or
Verifications, Inc. I understand only drug test results will be provided to and reviewed by a Verifications Inc. Medical Review Officer
(MRO) and that MRO may discuss the results of the drug test with me and ask about medical information specifically related to these
drug test results. I understand that when this review is completed, only the drug test result will be provided by the MRO to the above
named company and no other medical information about me will be disclosed to anyone without first asking for and obtaining my
specific consent to do so. I understand and authorize that some or all of this information about me may be transmitted electronically
and, when required, may be transferred across international boundaries.
I may request a copy of any report that is prepared
regarding me and
and substance of all information about me contained in the files of the consumer-reporting agency. I understand I have the right to
inspect those files with reasonable notice during regular business hours and I may be accompanied by one other person. The
consumer-reporting agency is required to provide someone to explain the contents of my file. I understand proper identification will be
required and I should direct my request to: Verifications, Inc., 1425 Mickelson Drive, Watertown, SD 57201, USA. Phone
1-800-247-0717 / +1 605-884-1200
If currently employed: My current employer may be contacted. YES NO __ N/A Post Hire Only A pplicant's Initials

I authorize the above-named company to procure a Consumer Report about me from Verifications, Inc. I hereby certify all the statements
and answers set forth are true and complete to the best of my knowledge. I am willing that a photocopy of this authorization be accepted
with the same authority as the original; and that if employed by the above-named company this authorization will remain in effect
throughout such employment unless prohibited by applicable law or I withdraw my authorization in writing.

Signature Social Security Number Date If the person authorizing the Consumer Report is under the age of 18, consent
of a parent or guardian is needed.

Signature of Parent or Guardian Printed Name Date

NOTE: Do not provide the following information until you have read and signed the Disclosure and Release of Information
Authorization above. The information requested below is needed to conduct your background investigation and IS NOT considered
part of your application. PLEASE PRINT CLEARLY.
 Name Address Middle Name City
Last
Street First Name Date of Birth (spell month)
Province
Country ZIP/Postal Code
State/
Country/State of License
No. Expires On

List any other COUNTRIES, CITIES, and STATES in which

you have lived during the previous 7 years
List any other LAST NAMES you have used during the
previous 7 years
List any other LAST NAMES under which you received your
GED, high school diploma, or other academic credentials.
If you have experience or qualifications from outside the USA, please request and complete an International Supplement.

CRIMINAL RECORDS VERIFICATION FORM

ACCOUNT/LOB : START DATE:

Please print all your answers legibly. Where the information required is not applicable to you, please place an N.A. on the space
provided. Fill out this form as accurately and as completely as possible. Information deliberately withheld will adversely affect your
application.

PERSONAL INFORMATION

1. Last Name

2. First Name

3. Middle Name

4. Complete Maiden Name (If married)

5. Birth Date (mm/dd/yy)

6. Current Address

7. Permanent Address

8. Civil Status

9. Gender at birth

If YES, please expound.

10. Have you ever been convicted of a [ ] Yes [ ] No
crime or offense in any country?

11. Is there any pending criminal action, a [ ] Yes [ ] No

court case or outstanding warrant filed
against you whether locally or overseas?

If YES, please expound.

I understand that, as part of my employment application, an investigation or verification of the information that I have placed on this form
may be required. Thus, I am giving my consent to carry out said investigation or verification to facilitate my employment application.
Verification of this information, however, is only a preliminary step to my employment but is not an assurance of my acceptance to Sykes
Asia, Inc.

With my full consent and authority,

(Applicant Signature over Printed Name)

Date:

Reviewed by:
(Recruitment Officer)

Last updated July 2021