21-2555 - P034-Customer Service Representative

Feb 19, 2024

Additional Personal Information

* = Conditionally Required

Pre-Employment Personal Information Form

Last Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rivera

First Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Jefferson
Middle Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cleofas
Maiden Name (Married Female Only) .
.....................................................
Format: First_Middle_Last Name
Present Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BLK 1 LOT 5 VISTA VERDE AVENUE NORTH EXECUTIVE SUBD. CAYBIGA
Contact Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0994 923 0720
Alternate Number . 09695123443
.....................................................
Email Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . terenzworldofficial2020@gmail.com
Birth Date 08/05/1989
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Birth Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Caloocan
Civil Status Single
Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Male
Mother's FULL Maiden Name .
..................................................... Rebecca Miranda Cleofas
Format: First_Middle_Last Name

Government Numbers

Social Security Number (SSS)

34-2033973-0
10-Digit Format: 12-3456789-0
Tax ID Number (TIN)
299-041-985
9-Digit Format: 123-456-789
Philhealth Number .
..................................................... 02-050673224-8
12-Digit Format: 12-345678910-1
Pag-IBIG Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1210-0661-6678
12-Digit Format: 1234-5678-9101
INVESTIGATIVE CONSUMER REPORT DISCLOSURE
INVESTIGATIVE CONSUMER REPORT DISCLOSURE

Afni, Inc.(the "Company") may request an investigative consumer report on you.

Under the federal Fair Credit Reporting Act, an investigative consumer report is a type of consumer report, or portion of a report, in which information on your character, general reputation,
personal characteristics, and/or mode of living is obtained through personal interviews with neighbors, friends, prior employers, associates or others with whom you are acquainted or who may
have knowledge concerning any such items of information. Commonly, the investigative consumer report involves personal interviews conducted for the Company, by a consumer reporting
agency, with an individual's prior employers or references.

You have the right to request disclosure of the nature and scope of any investigative consumer report obtained on you by contacting the Company.

Additionally, the federal Fair Credit Reporting Act gives you specific rights. Therefore, you also have a right to request A Summary of Your Rights Under the Fair Credit Reporting Act. For your
convenience, you will be provided A Summary of Your Rights Under the Fair Credit Reporting Act as a separate document.

PLEASE PROCEED TO THE NEXT DOCUMENT: "A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT"

Employment History PHI

To add additional employers, click the "Add Employer" button below.
The "Remove Last Employer" will delete all entries for the last employer that you have entered.

Please indicate all your employment history (BPO and non BPO experience) in the last 7 years. Start with your most recent employer.
In case the fields are not enough, kindly upload your updated resume on the requirements collection link that will be sent to your email upon accepting the job offer once hired.

Employment History

Previous Employment 1
Employer Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Previous
Employer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CONTINUUM GLOBAL
Employer Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09500434403
Start Position/Title . ACCOUNT ASSOCIATE II
.....................................................
End Position/Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACCOUNT ASSOCIATE
Start Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10/16/2023
End Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02/16/2024
Reason for Leaving . END OF CONTRACT (SEASONAL ACCOUNT)
.....................................................

Previous Employment 2
Employer Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Previous
Employer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VXI GLOBAL HOLDINGS
Employer Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09695123443
Start Position/Title . TECHNICAL SUPPORT
.....................................................
End Position/Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TECHNICAL SUPPORT SPECIALIST
Start Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10/09/2023
End Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11/16/2023
Reason for Leaving . REPROFILING OF ACCOUNTS
.....................................................

Previous Employment 3
Employer Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Previous
Employer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CONCENTRIX PHILIPPINES
Employer Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09695123443
Start Position/Title . TECHNICAL SUPPORT SPECIALIST
.....................................................
End Position/Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TECHNICAL SUPPORT SPECIALIST
Start Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03/01/2021
End Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03/30/2023
Reason for Leaving . CHANGE OF SITE FOR ACCOUNT
.....................................................

Previous Employment 4
Employer Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Previous
Employer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CAYBIGA HIGH SCHOOL
Employer Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09124418632
Start Position/Title . TEACHER I
.....................................................
End Position/Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TEACHER I
Start Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10/01/2012
End Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10/01/2022
Reason for Leaving . CHANGE OF CAREER
.....................................................

References - PHI

Please provide atleast 3 references. To add additional references, click the "Add Reference" button below.
The "Remove Last Reference" will delete all entries for the last reference that you have entered.

Only provide references that are familiar with your professional experience and/or academic accomplishments. Please DO NOT include family members or relatives.
** = conditional fields, not required unless you complete a required field that has the ** associated with it.

Character References (Co-worker/s, & Immediate Supervisor's from your most recent employer)

Additional Reference 1
Full Name* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AKISHA EARL CARAMOL
Relationship* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CO-WORKER
Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACCOUNT SPECIALIST
Reference Company . CONTINUUM GLOBAL INC
.....................................................
Reference Address . CALOOCAN CITY
.....................................................
Email Address* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . akishaearlcaramol@gmail.com
Contact Phone Number* . 09500434403
.....................................................

Additional Reference 2
Full Name* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LUISITO CARREON
Relationship* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CO WORKER
Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TEACHER III
Reference Company . CAYBIGA HIGH SCHOOL
.....................................................
Reference Address . VALENZUELA CITY
.....................................................
Email Address* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . luisito.carreon@deped.gov.ph
Contact Phone Number* . 09124418632
.....................................................

Additional Reference 3
Full Name* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . JERICHO FERRER
Relationship* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SUPERVISOR
Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TEAM LEADER
Reference Company . CONCENTRIX PHILIPPINES
.....................................................
Reference Address . BINAN LAGUNA
.....................................................
Email Address* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . jericho.ferrer@gmail.com
Contact Phone Number* . 09695123443
.....................................................

Education

School References

Highest Educational Attainment* . Bachelor's Level Degree

.....................................................
Name of School* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PHILIPPINE NORMAL UNIVERSITY
Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TAFT AVENUE MANILA
City* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MANILA
Course: (Vocational/Degree) . BS PSYCHOLOGY
.....................................................
Did you graduate?* . Yes
.....................................................
Last Date Attended . 03/29/2010
.....................................................
Authorization & Release - PHI

I hereby know and understand that as part of the Recruitment process, I shall be subjected to a background investigation commissioned by the
company. Hence, I hereby authorize the company and or its authorized representative to confirm and verify my employment including matters of
conduct / behavior, ability / reputation, education, family and employment as well as my financial and credit standing. I also authorize and request
each person ad firm referred in my Application Form to give such information. I understand that if I am employed, false statements, omissions or
misrepresentations may result in my dismissal.

E-Signature

In the field, please sign using your computer mouse or stylus.

Please enter name how it appears on your application: Jefferson Rivera

Electronic Signature . Jefferson Rivera
..................................................... Accepted
Time BG Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .