Attachment_3_-_Gardening.doc

ATTACHMENT 3

Biographical Data Form for Contractual Hires Diplomatic Security Investigative Unit (DSIU) 301-2661/301-2078 Full Name:_____________________________________________________________________________

(Last)

(First)

(Middle)

Present Address:____________________________________________Starting:_____________________ Provincial Address:__________________________________From:____________To:________________

Tel. No.:_____________________Date of Birth:________________Place of Birth:___________________

Other Names Used:______________________________________________________________________

(Maiden, Nickname, etc.)

Marital Status:_____________________Name of Spouse:_______________________________________

Height:____________Weight:____________ Hair Color:_____________Eye Color:__________________

RELATIVES: (Parents, Brothers, Sisters, and In-Laws)

EMPLOYMENT HISTORY: (Current and Last Three Previous Employers)

Position

Name & Address of Employer Date

Reason for Leaving

Have you ever been fired or forced to resign for any reason? (If yes, give details):

Have you ever been arrested or charged with any offense by the police or the military? (If yes, provide full details):_______________________________________________________________________________

Are you now, or have you ever been, a member of any organization or association that advocates the overthrow of the United States Government by force or violence? (If yes, provide full details): ______________________________________________________________________________________

CERTIFICATION

I certify that the information above is true, complete, and correct, to the best of my knowledge.

Signature

Date Please Submit the Following to DSIU – Room 138-B, NOX 1 Building

FIRST TIME BADGE AND RECORD CHECK

· Original copy of NBI clearance

· Original copy of Barangay clearance

· Original copy of Police clearance

· Biographic data form

· Cover memo from Employer/Section Head

· 2X2 ID picture

FOR BADGE RENEWALS ONLY

· Cover memo from Employer/Section Head

· Biographic data form

· 2x2 ID picture