CONFIDENTIAL

COMPLETE BACKROUND INVESTIGATION (CBI)

I. PERSONAL DATA:

Name:
Date of Birth:
Place of Birth:
Age:
Address:
Sex:
Civil Status:
Religion:
Blood Type:
Build:
Weight:
Height:
Complexion:
Ethnic Group:
CP No:

II. EDUCATIONAL BACKGROUND:

School Location Dates of Year Awards

attendance Graduated received
Elementary
Secondary
Vocational
College:

Course
Eligibilities RATING WHERE/WHEN TAKEN

BACKGROUND IN SCHOOL, ACTIVITIES/ORGANIZATION

III. PLACE OF RESIDENCE SINCE BIRTH:

Inclusive Date Address (include number of street

and barangay)
Since Birth to Date

This document contains classified information and is subject to secrecy and proper handling. This information may only be used for official
internal purposes of the recipient and must not be disclosed to another agency or third party without the prior written consent of the PNP.
The recipient must ensure that appropriate security measures are in place to protect the information from unauthorized access, use or
disclosure and must restrict access to recipient personnel on a “need to know” basis only.
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IV. EMPLOYMENT RECORDS:

Agency/Company Address Type/Nature Inclusive Reason for

of Dates and leaving
Employment nr. of years
/Position of service

V. IF MARRIED:
Name of Spouse:
Date of Birth:
Place of Birth:
Address:
Nationality:
Date of Marriage:
Occupation:
Name of Children Son/Daughter Date of Birth Place of Birth

VI. FAMILY HISTORY:

Father’s Name Date of Birth Place of Birth Occupation Address

Mother’s Name Date of Birth Place of Birth Occupation Address

Brothers/Sisters Date of Birth Place of Birth Occupation Address

VII. POLICE HISTORY:

VIII. CHARACTER REFERENCES:

1.
2.
3.

This document contains classified information and is subject to secrecy and proper handling. This information may only be used for official
internal purposes of the recipient and must not be disclosed to another agency or third party without the prior written consent of the PNP.
The recipient must ensure that appropriate security measures are in place to protect the information from unauthorized access, use or
disclosure and must restrict access to recipient personnel on a “need to know” basis only.
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IX. NEIGHBORHOOD INVESTIGATION:

X. CREDIT RECORDS: (Check and discuss the credit records)

According to subject person, she has no credit to any lending institution in the
community or any stores and establishment in the province.

XI. FOREIGN TRAVEL:

Date:From____________to___________Country___________________________
Nature of Work_____________________

XII. FOREIGN CONNECTION:

Subject person connection is

XIII. CITIZENSHIP STATUS:

Subject person is a bona fide Filipino citizen as per his birth certificate issued by the
National Statistic office, Central office Manila.

XIV. ORGANIZATION:

Subject is not a member of any organization

XV. PRINCIPAL AMUSEMENT:

XVI. AGENCY CHECK:

LOCAL AGENCY CHECK:

 Regional Trial Court : No Derogatory Records

 Municipal Trial Court: No Derogatory Records
 Prosecutor’s Office: No Derogatory Records
 NBI: No Derogatory Records
 Police: No Derogatory Records
 Barangay: No Derogatory Records

XVII. USE OF INTOXICANTS AND DRUGS:

Subject person is not taking any intoxicating substance or using any dangerous drugs
that might affect her good reputation and integrity.

XVIII. ANALYSIS:

Subject person has the determination

XIX. RECOMMENDATIONS:

Subject person is an

This document contains classified information and is subject to secrecy and proper handling. This information may only be used for official
internal purposes of the recipient and must not be disclosed to another agency or third party without the prior written consent of the PNP.
The recipient must ensure that appropriate security measures are in place to protect the information from unauthorized access, use or
disclosure and must restrict access to recipient personnel on a “need to know” basis only.
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Prepared by: Reviewed by:

This document contains classified information and is subject to secrecy and proper handling. This information may only be used for official
internal purposes of the recipient and must not be disclosed to another agency or third party without the prior written consent of the PNP.
The recipient must ensure that appropriate security measures are in place to protect the information from unauthorized access, use or
disclosure and must restrict access to recipient personnel on a “need to know” basis only.
CONFIDENTIAL