Synchrony Global Services Philippines Inc.

15th – 18th Floor, Ayala Center Cebu Tower,

Bohol Street, Cebu Business Park
Cebu City, Cebu 6000

PRE-EMPLOYMENT VERIFICATION CONSENT

TERMS and CONDITIONS

In connection with my employment application for the position of __________________________________, I would

like to allow Synchrony Global Services, Inc (the “Company”) and its third party background checking agency to:
 Obtain a police/NBI/Local Barangay record check and public record check in my name (additional consent
forms may be requested;
 contact and obtain information from my referees; and
 collect and verify any other sensitive information contained in my application form, in this form, resume and
supporting documents, including but not limited to the statements I provided during the employment interview
and subsequent discussions made throughout the recruitment process.
 authorize Synchrony Global Services Philippines, Inc. to verify information presented on application form, this
form, resume, SSS#, TIN, School record as but not limited to TOR/Diploma, and Certificate of Employment to
procure an investigative report.

PERSONAL INFORMATION VERIFICATION (Ensure you completely fill out the form; Leave space ‘blank if Not Applicable)

First Name:

Middle Name:

Last Name:

Date of Birth (MM/DD/YYYY):

Place of Birth:

Complete & Present Home Address:

Zip Code:

Mobile #:

Home Phone #:

Email Address:

Civil Status:

Gender: Male Female

Mother’s Maiden Name:

SSS #:

TIN #:

PhilHealth #:

Pag-Ibig #:

Emergency Contact Person:

Relationship to Emergency Contact
Person:
Emergency Contact Number:

CHARACTER VERIFICATION (Provide your previous supervisor or colleagues; anyone who is not part of your family/relatives)

Reference 1 Reference 2
Name:
Relationship to Candidate:
Contact Number:

Pre-Employment Verification Consent Page 1 of 2

 Synchrony Global Services Philippines Inc.
15th – 18th Floor, Ayala Center Cebu Tower,
Bohol Street, Cebu Business Park
Cebu City, Cebu 6000

EDUCATION VERIFICATION (Ensure you completely fill out the form; Leave space ‘blank if Not Applicable)

Please indicate information pertaining your highest educational attainment.

*Last School Attended:

Degree / Course Taken:

Years Attended:

Year level reached:

Year Graduated (if applicable):

Other School Attended (if applicable)

Degree / Course Taken:

Years Attended:

Year level reached:

Year Graduated (if applicable):

EMPLOYMENT VERIFICATION (Ensure you completely fill out the form; Leave space ‘blank if Not Applicable)

Please state your employers for the past 5 years, starting from the most recent.

.NAME OF EMPLOYER EMPLOYER ADDRESS FROM TO

CONSENT

By signing this form, I certify that the statements and information I provided in relation to employment application are true
and complete. I understand and agree that a false or misleading statement may disqualify me from employment or result
in dismissal.

By ticking the box and by affixing my signature/e-signature, email consent and/or copy of my CTC/Valid
ID No., I certify that I have read and consent to the terms and conditions stated above.

Full Name Signature Date Signed

Valid ID Type CTC / Valid ID No. CTC/ Valid ID Exp. Date

Pre-Employment Verification Consent Page 2 of 2