Document No:
BACKGROUND CHECK
Revision No: 1
AUTHORIZATION FORM
Effective Date:
(Personal Data Protection Act 2010 (“PDPA 2010”), Credit Reporting Agency Act 2010 (“CRA Act 2010”) and
Central Bank of Malaysia Act 2009)
By signing this Consent Form, I,
___________________________________________________________________, bearing the NRIC / Passport
No.:______________________________________ hereby grant informed consent to the organization with whom I
am seeking employment, herein referred as ‘the Company’, and to their appointed third-party screening company,
VENOVOX Group of Companies, herein referred as ‘the Screening Company’, to conduct Pre and/or Post
Employment background screening as part of the recruitment process in assessing my suitability for the position
applied. The Screening Company act as the Representatives (located within and outside Singapore) engaged by my
employer to perform certain functions connected to employment, so long as disclosure is necessary to enable use
such Representatives to perform the said functions.
The company is hereby authorized to release to the Screening Company any and all information concerning my
employment or application and I agree to hold the company blameless and free of any liability for releasing any such
information.
I authorize the relevant agencies and entities to disclose to the Screening Company and its agents all information
about or concerning me, including but not limited to: my past or present employers; learning institutions, including
colleges and universities; law enforcement and all other government agencies; federal, state and local courts; credit
bureaus; all other private and public sector repositories of information; and any other person, organization, or agency
with any information about or concerning me within their knowledge or record, and I agree to hold any or all of them
blameless and free of any liability for releasing any truthful information that is within their knowledge or records.
I also agree to hold the Company blameless and free of any liability for using any information received from such
parties in making an employment decision regarding me. I understand that the Company may rely on this
authorization to order additional background reports, including investigative consumer reports, during my employment
without asking me for my authorization again as allowed by law.
I agree that a copy of this form is valid like the signed original. I certify that all of the personal information I provided is
true and correct. I understand that misrepresentation or omission will constitute sufficient ground for rejection or for
subsequent dismissal if I am hired.
ACKNOWLEDGEMENT AND RELEASE
I acknowledge receipt of this letter. I release your company and its employees and agents from all liability
relating to your obtaining and use of such information solely and only for the purpose of being evaluated for
a recruitment position. I authorize all companies, schools, organizations, registered credit reporting agency
under the CRA Act 2010 and other persons to process my personal data as per the PDPA 2010 and provide
such information to you and your agents and release them from all liability for doing do so.
Candidate’s Signature Date
Candidate’s Name (typed or printed) NRIC / PASSPORT NO: