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Background Investigation

BI Community Check Interview Form

Email * FV Name * FV's Contact No. * Client Code * Subject's Name * Ocular Date * Subject's Given Address * Correct/Complete Address * Address Verification Result *

Confirmed (explain status of residency in next section) Moved Out Unlocated Address Located address but Unknown Person Not Confirmed

Confirmed Residency Status/Details * The Subject's length of stay at the given address * Ownership of the given address *

Owned by the subject Owned by subject's family Parents Relatives In-laws Inherited Rented Other

If Other, please specify the ownership Explain what other type of ownership If Renting (Monthly Rent Amount / Paying Habits) The Subject is living with whom *

Spouse Common-Law Partner Children Parents Siblings In-laws Relatives Friends Other

If Other, please specify who the subject is living with Explain who else the subject is living with Type of Structure *

Bungalow (single detached) Townhouse Condo One-storey house (single attached) Two-Storey House Multi-Storey House Mansion Apartment Unit Bliss Rowhouse Shanty Duplex N/A

Community Description *

Exclusive Residential Subdivision Residential Area Commercial Area Mixed Commercial / Residential Industrial Area Mixed Industrial / Residential Business Central District Depressed / Squatters Area N/A

Make *

Concrete Semi-Concrete Wood N/A

Maintenance *

Well Maintained Fairly Maintained Poorly Maintained Under Construction N/A

Community Income Classification *

High Income Middle Income Low Income N/A

Subject's Status of living *

High income Middle income Low income N/A

Landmarks * Notable landmark and distance from the given address Address Verification other information gathered * Other relevant information like road conditions, densely or sparsely populated, peaceful or hostile community HOA/Admin information (if residence is inside a subdivision or condominium building) Association dues, paying habits, debts and ownership of the given address For Moved Out only Why and when did the subject moved out? Where is the current location? How long lived at address? Who is current occupant? Who is owner? For Unknown Person only Identify current occupants? How long living there? Other information gathered For Unlocated Address only Detailed description and efforts done in locating the given address Barangay Checking Result *

Registered Resident Not Registered Resident Registered Voter Not Registered Voter With Derogatory Records Without Derogatory Records No Information Gathered

If No Information Gathered, please explain why Explain why no information was gathered from barangay Barangay Checking Result Details * Name of Informant / Position / Statement (registered resident/derogatory remarks) Person Interviewed (for Disclose Verification Only) Name / Relationship / disclosure on subject's personality Neighbor Informants * Name / Relationship / Address / Length Known / statement or disclosure on subject's personality Nickname / Alias * Name where the subject is commonly known in the community Age * Subject's Civil Status *

Single Married Separated Annulled Widow With common law partner N/A

Subject's Spouse / Partner Information * Name / Native Province / Work Children's Information * Name / School or Work / Other info Subject's Parents * Name of father and mother / their Native Province, Address, Work Sibling's Information * Family Background * To gather info on family reputation, relationships (troubled relationships), marital problems, medical conditions, family debts, etc. Family Government Affiliation * If subject has any relative or family member working in government or politician. State position and branch. (For bank client only) Common pastime/Activities * Membership in organization * Vacation trips * Vices * Involvement of subject in any illegal or immoral activities * Extravagant lifestyle * Subject's source of income * Subject's debts and paying habits * Subject's family medical expenses * Adverse Remarks *

NONE Marital Problem Domestic / Family Issues Unsettled Debts Drugs Attitude Problem Alcoholism Gambling Other

If Other, please specify the adverse remarks Explain what other adverse remarks were observed For Discreet Verification and it was compromised (accidentally/unintentionally interviewed the subject or family member), please explain in details the incident Other relevant information gathered

Picture of Given Address

Picture of Informant 1's Residence

Picture of Informant 2's Residence

Picture of Informant 3's Residence

Picture of Barangay Hall without and with Selfie (2 pictures)

Section

ANTI-SUHOL REPORT

Report within 24 hours if you have experienced any form of bribery in kind or in cash while you were conducting verification.

Did you experience any type of bribery?(Material / Food/ Money/ Favors) Report the incident and any unlawful activities encountered. *

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