APPLICATION FORM. Overseas Criminal Record Check SRI LANKA
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1 APPLICATION FORM Overseas Criminal Record Check SRI LANKA
2 Overseas Criminal Record Check Application Form Guidance Notes This application form captures the data required by GB Group Plc, in order to process an overseas criminal record check in Sri Lanka. Before you start, please read all the information below to help ensure you complete this simple form, accurately. Information Required: Please ensure all fields are complete and the full application has been completed by only the applicant. Information required includes: o Your personal details, such as full name and date of birth o Your current address and previous address history for the past 10 years o Signed consent form Please follow these steps and complete the following application form. To confirm you give your consent please ensure you sign and date the Release of Information form attached in Section 3 of the application form. Without your wet signature and date as proof of consent the application cannot be processed Page 1 of 5
3 The Application Form KnowYourPeople Application Form This form can either be completed electronically or printed out and filled in with black or blue ink. You must ensure to provide a wet signature in order to give your consent. Section 1 Personal Full Name: (First, middle, last) Date of Birth: DD/MM/YYYY Section 2 Address Details Please supply your current address and previous address history for the past 10 years. It is important that you do not leave any gaps between addresses. Your application cannot be processed without this information. Current Address Page 2 of 5
4 Previous Address # 1 Previous Address # 2 Previous Address # 3 Page 3 of 5
5 Previous Address # 4 Previous Address # 5 Previous Address # 6 * If more space is required to provide your full 10 year address history, please use a blank piece of paper and send, or scan this together with the signed application form. Page 4 of 5
6 Section 3 Applicant/Employee Notification / Release of Information The purpose of this form is to explicitly inform you and to obtain your prescribed consent to release to GBG and RISQ Group, incorporating AIM Screening, ( the Group ), agents of our company, the personal information provided by you to our Company or information about you collected and compiled by our company (the Information ) in the course of or in relation to the application for this Check. The Information will be released to the Group and/or its agents to conduct searches on your background information, which may include civil and criminal records, local language media information, as requested by our company (the Collected Information ). You hereby authorize our company through the Group and/or its agents, as well as the Group explicitly, to contact various government agencies and courts and other contributors (the Contributors ) as a relevant party acting on your behalf for the purposes of obtaining the Collected Information. This letter releases the Contributors from any liability and responsibility for releasing the Collected Information to our Company or the Group. The Group and/its agent may release the Information and this consent letter to the Contributors and such other persons as may necessary for the purposes of performing such searches. The Group will furnish to the customer a report containing the Collected Information (the Report ). The Report shall be the property of our company. Any request for a copy of the Report or details of the Collected Information contained therein shall be made to the Group in the first 60 days after signing this letter or after that period, directly to our company in writing. In signing this letter, you confirm that your consent is given voluntarily and shall remain valid and effective until and unless it is withdrawn by you with prior written notice. We acknowledge that the Group (and its agents) in collecting, holding, processing and using the Information, the Collected Information and such other related information and documents that may contain your personal data solely on behalf of us and does not hold, process or use this information for any of its own purposes. Release of Information I confirm that I have read the above Statement of Applicant/Employee Notification / Release of Information and give my consent by providing wet signature: Print Name: Applicant Signature: Date: PLEASE RETURN THIS FULLY COMPLETED APPLICATION FORM BACK TO YOUR EMPLOYER Page 5 of 5
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