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.
Signature over printed name
MARCH 3, 2024
Date Signed
Wave #: 23
Employee ID #
Account: CONSERVICE
Start Date: MARCH 6, 2024
PERSONAL DATA
FIRST NAME MIDDLE NAME LAST NAME SUFFIX
MONDY OLIVER CARIASO TUBIERA N/A
PRESENT ADDRESS
2ND GATE 21ST ST., MAWAQUE, MABALACAT CITY, PAMPANGA
PERMANENT ADDRESS
TUBIERA ST., BRGY. ABAR 1ST, SAN JOSE CITY, NUEVA ECIJA
APPLYING FOR THE POSITION OF CITIZENSHIP GENDER
CSR (/) Male
FILIPINO
( ) Female
CIVIL STATUS DATE OF BIRTH (MM/DD/YYYY) MOBILE NUMBER HOME PHONE NUMBER
(/) Single
( ) Married MAY 11, 2004 09557257668 09557257668
( ) Separated
( ) Widow/er
( ) Annuled/Divorced
EMAIL ADDRESS SSS NUMBER PAG-IBIG NUMBER PHILHEALTH NUMBER
mondytubiera71@gmail.com 0247787775 212526192122
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
Please indicate your employment details within the last 5 years. Do not leave any space blank. Fields with * are critical to complete
the background investigation.
NAME OF ORGANIZATION* CONTACT NUMBER
SUTHERLAND GLOBAL SERVICES
ADDRESS*
CLARKPORT, ANGELES CITY, PAMPANGA
EMPLOYMENT DATES From (MM/DD/YYYY) To (MM/DD/YYYY)
DECEMBER 15, 2022 FEBRUARY 20, 2024
POSITION (Upon hiring) POSITION (Upon leaving)
TECHNICAL SUPPORT REPRESENTATIVE TIER 2/TSR
NATURE OF EMPLOYMENT
(/) Full-Time ( ) Part-time ( ) Self-employed ( ) Internship
IMMEDIATE SUPERVISOR* CONTACT NUMBER*
JOHN DOMINIC CRISTOBAL 09616165294
REASON FOR LEAVING
CAREER GROWTH
NAME OF ORGANIZATION* CONTACT NUMBER
ALORICA CLARK
ADDRESS*
PHILEXCEL BUSINESS PARK, CLARKPORT, PAMPANGA
EMPLOYMENT DATES From (MM/DD/YYYY) To (MM/DD/YYYY)
MARCH 15, 2022 DECEMBER 7, 2022
POSITION (Upon hiring) POSITION (Upon leaving)
CSR/TSR CSR/TSR
NATURE OF EMPLOYMENT
(/) Full-Time ( ) Part-time ( ) Self-employed ( ) Internship
IMMEDIATE SUPERVISOR* CONTACT NUMBER*
JOY DELA PEÑA ABSALON 09535506251
REASON FOR LEAVING
CAREER GROWTH
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 are NOT valid references.
NAME OF REFERENCE RELATIONSHIP
PATRICIA ALYANAN COLLEAGUE
COMPANY NAME AND OCCUPATION CONTACT DETAILS
ALORICA 09657381807
NAME OF REFERENCE RELATIONSHIP
ZADIESHAR G. SANCHEZ FRIEND
COMPANY NAME AND OCCUPATION CONTACT DETAILS
PHILIPPINE CARABAO CENTER 09272359396
PROFESSIONAL CHARACTER REFERENCE 3
NAME OF REFERENCE RELATIONSHIP
JONALLYN DELA CRUZ COLLEAGUE
COMPANY NAME AND OCCUPATION CONTACT DETAILS
SUTHERLAND 09271900608
PROFESSIONAL CHARACTER REFERENCE 4
NAME OF REFERENCE RELATIONSHIP
ERITHES AGUILAR FRIEND
COMPANY NAME AND OCCUPATION CONTACT DETAILS
ALORICA 09656394030
NAME OF REFERENCE RELATIONSHIP
RUBEN MARIN III FRIEND
COMPANY NAME AND OCCUPATION CONTACT DETAILS
09168733615
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)
ADDRESS/BRANCH
CONTACT DETAILS NAME IN SCHOOL RECORDS
DEGREE/COURSE GRADUATION DATES (IF APPLICABLE - FOR COLLEGE GRAD ONLY)
STUDENT ID INCLUSIVE SCHOOL YEAR/S
NAME OF INSTITUTION (HIGH SCHOOL) SAN JOSE CITY NATIONAL HIGH SCHOOL
ADDRESS/BRANCH SJCNHS, SAN JOSE CITY, NUEVA ECIJA
CONTACT DETAILS NAME IN SCHOOL RECORDS
GRADUATION DATES (IF APPLICABLE - FOR HS GRAD ONLY)
STUDENT ID INCLUSIVE SCHOOL YEAR/S 2019-2021
Kindly extend assistance upon request of the information needed to complete the educational background
check.
Thank you.
Signature over printed name
MARCH 3, 2024
Date Signed
