BACKGROUND INVESTIGATION AUTHORIZATION FORM

I authorize 24-7 Intouch Ph Inc. and/or its authorized representative, to conduct a background investigation as part of
the application process.

I authorize and consent, without reservation to the retrieval of information that may include but not limited to
employment, matters of conduct, behavior, ability, reputation, credit standing, education, family, financial, and criminal
history.

By my signature below, I hereby declare that all information provided in this form are true to the best of my knowledge
and that any falsified or malicious information in this application will be sufficient grounds for resentment of offer or dismissal
upon discovery.

__________________________________________
JEN PHOEBE EBDANI DOMINGO
Signature over printed name

06/16/2023
__________________________________________
Date Signed

Wave #:

Employee ID #

Account: TURO

Start Date: 06/23/2023

PERSONAL DATA
FIRST NAME MIDDLE NAME LAST NAME SUFFIX
JEN PHOEBE EBDANI DOMINGO
PRESENT ADDRESS
34 KASAYAHAN STREET BATASAN HILLS QUEZON CITY
PERMANENT ADDRESS
34 KASAYAHAN STREET BATASAN HILLS QUEZON CITY
APPLYING FOR THE POSITION OF CITIZENSHIP GENDER
( ) Male
CUSTOMER SERVICE REPRESENTATIVE FILIPINO
( ) Female

CIVIL STATUS DATE OF BIRTH (MM/DD/YYYY) MOBILE NUMBER HOME PHONE NUMBER
( ) Single
( ) Married
( ) Separated 10/30/2001 09055479074
( ) Widow/er
( ) Annuled/Divorced

EMAIL ADDRESS SSS NUMBER PAG-IBIG NUMBER PHILHEALTH NUMBER

[email protected] 34-7984731-2 121237747821 03-026360093-9
HIGHEST EDUCATIONAL ATTAINMENT
( ) Masteral/Doctoral Degree ( ) Associate/2-Year Degree ( ) High School
Graduate ( ) Bachelor’s Degree ( ) Certificate/Diploma Course ( ) Some College
Please specify year level ____________

EMPLOYMENT HISTORY DETAILS

Please indicate your employment details within the last 5 years.Do not leave any space blank. Fieldswith * are critical to complete
the background investigation.

NAME OF ORGANIZATION* CONTACT NUMBER

INSPIRO RELIA INC (02) 884-6222

ADDRESS*
6TH FLOOR MEGAONE BUILDING, ESPANA BOULEVARD COR. MAYON STREET, QUEZON CITY
EMPLOYMENT DATES From (MM/DD/YYYY) To (MM/DD/YYYY)
01/11/2021 06/01/2021
POSITION (Upon hiring) POSITION (Upon leaving)
CUSTOMER SERVICE REPRESENTATIVE CUSTOMER SERVICE REPRESENTATIVE
NATURE OF EMPLOYMENT
( ) Full-Time ( ) Part-time ( ) Self-employed ( ) Internship

IMMEDIATE SUPERVISOR* CONTACT NUMBER*

KATHERINE BASTO MARTIN [email protected]
REASON FOR LEAVING
END OF CONTRACT
NAME OF ORGANIZATION* CONTACT NUMBER

ADDRESS*

EMPLOYMENT DATES From (MM/DD/YYYY) To (MM/DD/YYYY)

POSITION (Upon hiring) POSITION (Upon leaving)

NATURE OF EMPLOYMENT
( ) Full-Time ( ) Part-time ( ) Self-employed ( ) Internship

IMMEDIATE SUPERVISOR* CONTACT NUMBER*

REASON FOR LEAVING

NAME OF ORGANIZATION* CONTACT NUMBER

ADDRESS*

EMPLOYMENT DATES From (MM/DD/YYYY) To (MM/DD/YYYY)

POSITION (Upon hiring) POSITION (Upon leaving)

NATURE OF EMPLOYMENT
( ) Full-Time ( ) Part-time ( ) Self-employed ( ) Internship

IMMEDIATE SUPERVISOR* CONTACT NUMBER*

REASON FOR LEAVING

NAME OF ORGANIZATION* CONTACT NUMBER

ADDRESS*

EMPLOYMENT DATES From (MM/DD/YYYY) To (MM/DD/YYYY)

POSITION (Upon hiring) POSITION (Upon leaving)

NATURE OF EMPLOYMENT
( ) Full-Time ( ) Part-time ( ) Self-employed ( ) Internship

IMMEDIATE SUPERVISOR* CONTACT NUMBER*

REASON FOR LEAVING

NAME OF ORGANIZATION* CONTACT NUMBER

ADDRESS*

EMPLOYMENT DATES From (MM/DD/YYYY) To (MM/DD/YYYY)

POSITION (Upon hiring) POSITION (Upon leaving)

NATURE OF EMPLOYMENT
( ) Full-Time ( ) Part-time ( ) Self-employed ( ) Internship

IMMEDIATE SUPERVISOR* CONTACT NUMBER*

REASON FOR LEAVING

NAME OF ORGANIZATION* CONTACT NUMBER

ADDRESS*

EMPLOYMENT DATES From (MM/DD/YYYY) To (MM/DD/YYYY)

POSITION (Upon hiring) POSITION (Upon leaving)

NATURE OF EMPLOYMENT
( ) Full-Time ( ) Part-time ( ) Self-employed ( ) Internship

IMMEDIATE SUPERVISOR* CONTACT NUMBER*

REASON FOR LEAVING

NAME OF ORGANIZATION* CONTACT NUMBER

ADDRESS*

EMPLOYMENT DATES From (MM/DD/YYYY) To (MM/DD/YYYY)

POSITION (Upon hiring) POSITION (Upon leaving)

NATURE OF EMPLOYMENT
( ) Full-Time ( ) Part-time ( ) Self-employed ( ) Internship

IMMEDIATE SUPERVISOR* CONTACT NUMBER*

REASON FOR LEAVING

PROFESSIONAL CHARACTER REFERENCE

Please provide five (5) professional character references and their details.
For fresh graduates, please provide us details of five (5) character references who have known
you personally. Note: Relatives areNOTvalid references.

PROFESSIONAL CHARACTER REFERENCE

1 NAME OF REFERENCE RELATIONSHIP

IAN MAGHARI COLLEAGUE

COMPANY NAME AND OCCUPATION CONTACT DETAILS

QUANTRICS / CUSTOMER SERVICE REPRESENTATIVE 09126412811

PROFESSIONAL CHARACTER REFERENCE

2 NAME OF REFERENCE RELATIONSHIP

RONIE GAYAP COLLEAGUE

COMPANY NAME AND OCCUPATION CONTACT DETAILS

TELUS INTERNATIONAL / CUSTOMER SERVICE REPRESENTATIVE 09951540302

PROFESSIONAL CHARACTER REFERENCE

3 NAME OF REFERENCE RELATIONSHIP

KATHERINE BASTO MARTIN TEAM LEADER

COMPANY NAME AND OCCUPATION CONTACT DETAILS

TELUS INTERNATIONAL / TEAM LEADER [email protected]

PROFESSIONAL CHARACTER REFERENCE

4 NAME OF REFERENCE RELATIONSHIP

GILBERT TAPIA MANAGER

COMPANY NAME AND OCCUPATION CONTACT DETAILS

KENNY ROGERS ROASTER / ASSISTANT MANAGER 09354910902

PROFESSIONAL CHARACTER REFERENCE

5 NAME OF REFERENCE RELATIONSHIP

ALLYSA CALAMBA FRIEND

COMPANY NAME AND OCCUPATION CONTACT DETAILS

CONCENTRIX / SUBJECT MATTER EXPERT 09557920624
 AUTHORIZATION FOR EDUCATION CHECK

To the Registrar's Office

To whom it may concern:

This is to authorize confirmation and verification of 24-7 Intouch Ph Inc., through their official representative, on
my education records based on my stated information below:
NAME OF INSTITUTION (COLLEGE/POST GRADUATE STUDIES)
STI COLLEGE CUBAO
ADDRESS/BRANCH
P. TUAZON BLVD., CORNER 5TH AVENUE., CUBAO, QUEZON CITY
CONTACT DETAILS NAME IN SCHOOL RECORDS
TEL NO.: 4211029 JEN PHOEBE E. DOMINGO
DEGREE/COURSE GRADUATION DATES (IF APPLICABLE - FOR COLLEGE GRAD ONLY)
BA COMMUNICATION N/A
STUDENT ID INCLUSIVE SCHOOL YEAR/S
02000244746 2021-2022

NAME OF INSTITUTION (HIGH SCHOOL)

BATASAN HILLS NATIONAL HIGH SCHOOL
ADDRESS/BRANCH
IBP ROAD, BATASAN HILLS, QUEZON CITY 1126
CONTACT DETAILS NAME IN SCHOOL RECORDS
(02) 3428 1973 JEN PHOEBE E. DOMINGO
GRADUATION DATES (IF APPLICABLE - FOR HS GRAD ONLY)
APRIL 05, 2019
STUDENT ID INCLUSIVE SCHOOL YEAR/S
2013-2019

Kindly extend assistance upon request of the information needed to complete the educational
background check.

Thank you.

_____________________________________
JEN PHOEBE EBDANI DOMINGO
Signature over printed name
_____________________________________
06/16/2023
Date Signed