3rd

Flr,
PHOTO
CIFC
Tower, Juan Luna Avenue Extension, Cebu City,
Central Visayas, Philippines

APPLICATION FORM
Instructions: Please complete the blanks with correct information.

PERSONAL INFORMATION

Last Name First Name Middle Name Date of Birth Age Civil Status Gender

Nick Name Citizenship Place of Birth

Present Address:
No./Street Barangay District/Municipality Zip Code
City/Province

Permanent Address:
No./Street Barangay District/Municipality Zip Code
City/Province

SSS No. TIN No. PAG-IBIG No. PHILHEALTH No. RELIGION Distinguishing Mark Position Applied

Please Select

CONTACT INFORMATION
Note: Frequently used number/email address.

Mobile number 1 Mobile number 2 Home number 1 Home number 2 Office number Email Address 1 Email Address 2

EMPLOYMENT BACKGROUND
Note: Starts from most recent employment.
Date of Employment<mm/dd/yy> Reason for
Name of Company Position Title Salary Contact no. Leaving
Start End

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Have you ever been convicted to any crime or violation of any law, Decree, YES NO
ordinance or regulation by any court or tribunal?
If Yes, give details:

Have you ever been separated from the service in any of the following: YES NO
Resignation, retirement, dropped from the rolls,
dismissal, termination,
End of term, finished contract or abolition in private or gov’t sector? If Yes, give details:

Pursuant to : a) Indigenous People’s Act (RA 8371), b) Magna Carta For NO

Disabled Persons (RA 7277); and c) Solo Parents Welface Act of 2000 (RA
8972), please answer the following: YES
a) Are you a member of any indigenous group? If Yes, give details:

NO
YES
b) Are you a person with disability?
If Yes, give details:
NO

YES
c) Are you a solo parent?
If Yes, give details:

Have you ever applied for any position in Flexi Finance Asia Inc before? YES NO
If Yes, what was the status?

If Yes, give details:

Have you ever availed of Flexi Finance Asia Inc. Services? YES NO
If Yes, give details:

Have you availed of Flexi Finance Asia Inc., sales and cash loan services and YES NO
currently paying it?
If Yes, give details:

NON-DISCLOSURE STATEMENT

I declare that the information given in this application information sheet are personally accomplished by me which
is true and accurate to the best of my knowledge. I understand that any misrepresentation of facts herein will be a
sufficient cause for disqualification from the opportunities of the recruitment process.
Further, if I am employed and any non-disclosure of information will be grounds for termination of my employment
and shall cause the filing of administrative / criminal case/s against me.

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 I hereby allow FLEXI FINANCE ASIA INC. Head/ representative to verify / validate the contents stated herein. The
right to conduct investigation of my former employers, and all other parties, including but not limited to educational
institutions where I enrolled to fully check on my background.

<Signature over printed Name> Date

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