precise background services telstra employment pack 1

precise background services telstra employment pack 1 Introduction As part of the recruitment process, Telstra have appointed Precise Background Services to carry out a range of pre-employment checks on you. In order for us to do this, we require this form to be completed in full. The completion of this form and assessment of the information you provide is conducted as a part of Telstra's standard recruitment processes for the role for which you have applied. Your employment with Telstra is subject to and conditional upon the results of the pre-employment checks being received and assessed to the satisfaction of Telstra. Please use a Blue or Black pen and print clearly. Do not use white out or white out roller tape. If you make an error, please cross it out and complete correct answer. Precise Background Services must have a signed copy of this form to carry out background checking. Should you require more space for some sections, please attach on a separate page. Upon completion of this form please print and sign in the relevant places where indicated, attach the requested documents and return to us at: Team Telstra Careers Centre Email to: Telstra.Background.Checks@team.telstra.com Please provide copies of the following documents: (please check ) A copy of any academic or tertiary certificates. A copy of all professional memberships. A copy of all professional licences, registrations and/or certificates. Completed National Criminal History Record Consent which is attached to the end of this form. Copy of Resume SECTION 1: EMPLOYER DETAILS: (Please enter details of the company you are seeking employment with) Business Unit/ Cost Centre: Contact Person: Contact No: (B/H) (M) Advertised Position: Ref No: SECTION 2: YOUR PERSONAL DETAILS Family Name: Given Name/s: Current address (include unit/street no): Suburb/City State Postcode Date of Birth (DD,MM,YYYY) / / Do you hold a current driver s licence? Yes [ ] No [ ] If yes, please provide details: Drivers Licence no: Conditions: (if applicable) Previous Names if applicable (i.e.: Maiden name etc) Family Name: Given Names: Date of Name Change: / / Current Contact Numbers: Home: Fax No: Work: Mobile: Email Address: @ Precise Background Services - Telstra Employment PACK 1 1

SECTION 3: CURRENT/OR PREVIOUS EMPLOYER/s (over the last 10 years, most recent first) Company Name: Address: Suburb/City State Postcode Country Contact Phone No: Salary Package (or hourly rate) Current (or most recent) Position held including period: (DD,MM,YYYY) to (DD,MM,YYYY) Who is your line manager?: Name Position: Contact Details: How long have you reported to this person: Please advise any previous position(s) held with the company including period: (DD,MM,YYYY) to (DD,MM,YYYY) Responsibilities: Reason for leaving/or wishing to leave: PREVIOUS EMPLOYMENT (over the last 10 years) Company Name: Address: Suburb/City State Postcode Country Contact Phone No: Salary Package (or hourly rate) Current (or most recent) Position held including period: (DD,MM,YYYY) to (DD,MM,YYYY) Who is your line manager?: Name Position Contact Details: How long have you reported to this person: Please advise any previous position(s) held with the company including period: (DD,MM,YYYY) to (DD,MM,YYYY) Responsibilities: Reason for leaving/or wishing to leave: Precise Background Services - Telstra Employment PACK 1 2

PREVIOUS EMPLOYMENT (over the last 10 years) Company Name: Address: Suburb/City State Postcode Country Contact Phone No: Salary Package (or hourly rate) Current (or most recent) Position held including period: (DD,MM,YYYY) to (DD,MM,YYYY) Who is your line manager?: Name Position Contact Details: How long have you reported to this person: Please advise any previous position(s) held with the company including period: (DD,MM,YYYY) to (DD,MM,YYYY) Responsibilities: Reason for leaving/or wishing to leave: SECTION 4: PROVIDE DETAILS OF ANY GAPS IN EMPLOYMENT (i.e.: travelling) (DD,MM,YYYY) to (DD,MM,YYYY) Explanation for gap in employment: (DD,MM,YYYY) to (DD,MM,YYYY) Explanation for gap in employment: (DD,MM,YYYY) to (DD,MM,YYYY) Explanation for gap in employment: SECTION 5: EDUCATION & QUALIFICATIONS (TERTIARY) (Please list most recent achievement in order) University/College Name: Address: Suburb/City State Postcode Country Contact Phone No: Date attended from: (DD,MM,YYYY) / /. to (DD,MM,YYYY) / /. Name at time of Qualifying (if different): Qualification Received: Date Received: (DD,MM,YYYY) / /. Student ID No: Precise Background Services - Telstra Employment PACK 1 3

University/College Name: Address: Suburb/City State Postcode Country Contact Phone No: Date attended from: (DD,MM,YYYY) / /. to (DD,MM,YYYY) / /. Name at time of Qualifying (if different): Qualification Received: Date Received: (DD,MM,YYYY) / /. Student ID No: SECTION 6: PROFESSIONAL MEMBERSHIPS (If applicable, please list your most recent professional membership/qualification - only list your three highest or most relevant memberships or qualifications) Name of Institution: Address: Suburb/City State Postcode Country Contact No: Qualification Awarded / Membership Status: Membership Reference No. Date Joined: (DD,MM,YYYY) / /. Name of Institution: Address: Suburb/City State Postcode Country Contact No: Qualification Awarded / Membership Status: Membership Reference No. Date Joined: (DD,MM,YYYY) / /. SECTION 7: LICENCES, CERTIFICATES, REGISTRATIONS (If applicable, please list details of your current practicing licences, certificates and/or registrations) Name of Issuing Authority: Address: Suburb State Postcode Contact No: Reference No. Date Joined: (DD,MM,YYYY) / /. Date of expiry / /. Precise Background Services - Telstra Employment PACK 1 4

SECTION 8: MANAGEMENT &/OR DIRECTOR QUESTIONS: Please answer the following questions. If you answer Yes to any of these questions provide relevant details. 8.1 Have you ever been a director of a Pty Ltd company? If yes, provide details. No [ ] Yes [ ] Details: 8.2 Have you ever been disqualified from acting as a Director? If yes please provide details. No [ ] Yes [ ] Details: 8.3 Have you ever declared bankruptcy? If yes please provide details and advise if you are currently an undischarged bankrupt. No [ ] Yes [ ] Details: 8.4 Do you have any financial judgements or defaults against you in the capacity of Director? No [ ] Yes [ ] Details: Precise Background Services - Telstra Employment PACK 1 5

SECTION: 9 CONSENT TO BACKGROUND CHECK DECLARATION I, First Name: Surname: Authorise Precise Background Services or persons or organisations acting on its behalf to complete independent background checks to verify information provided in this application. I understand that from this background check an employment report will be completed and provided to authorised persons. It is acknowledged and understood by me that this employment report may relate to information about my background and personal reputation. I agree that this employment record will only be used in relation to other or further employment decisions. I also consent and authorise Precise Background Services to complete background and reference checks in respect of my employment history. I understand that my current employer will not be contacted unless I specifically provide signed consent for such contact. I authorise Precise Background Services to verify information I have provided in relation to my educational and professional qualifications, and any further details I have provided that relate to this application only. I release from liability all persons or entities who provide information in this application. I acknowledge that failure to fully disclose or provide information which is materially wrong may end employment or any offer of employment. All information in this application is given in good faith and to the best of my knowledge in true and correct at the time of this application. Applicant to Sign: (sign when printed) Date: / / (date when printed) Precise Background Services Precise Background Services primary business is the verification of information provided by job applicants and current employees along with a range of investigative services. Protecting your Privacy Precise Background Services is committed to providing you with the highest levels of customer service. This includes protecting your privacy. Precise Background Services is bound by the Commonwealth Privacy Act 1988, which sets out a number of principles concerning the protection of your personal information. Set out below is information that Precise Background Services is required to communicate to its customers. Precise Background Services recommends that you keep this information for future reference. Your personal information: We may conduct background checks regarding your employment history and references, education, professional qualifications, residency and immigration status, criminal record check, claims, judgments, current and previous directorships and other records available to the public. Other information gathered may include your name, date of birth, current and previous addresses, telephone/mobile telephone number, email address, bank account or credit card details, current & past occupation, driver's licence number. Precise Background Services also hold certain details about your personal interests. All personal information is provided on our forms downloaded from our internet site or supplied directly to you. All information relating to your name, date of birth, gender, previous /maiden names and national origin do not factor in your eligibility for employment. This information is solely required for use when obtaining and verifying information from government or other sources who require these details in order to provide us with the information we require. Occasionally, you may need to provide personal information about other individuals to Precise Background Services. If so, Precise Background Services relies on you to inform those individuals that you are providing their personal information to Precise Background Services and to advise them that Precise Background Services can be contacted for further information. Precise Background Services - Telstra Employment PACK 1 6

How we use your personal information Your personal information may be used to:. verify your identity;. verify your previous work history;. determine your suitability to be employed within the environment that you have either applied for or are currently in;. verify the accuracy of the information that you have provided to either your prospective or current employer;. conduct appropriate checks for credit-worthiness and/or fraud. When we disclose your personal information Your personal information is disclosed only to those organisations to which we have been contracted and to whom you have provided a written authority. Precise Background Services takes reasonable steps to ensure that these organisations are bound by confidentiality and privacy obligations in relation to the protection of your personal information. You can access your personal information You have a right to access your personal information, subject to some exceptions allowed by law. If you would like to do so, you will need to put your request in writing, for security reasons, and either send it by mail to Precise Background Services, PO Box 14 Thomastown VIC 3074, Vic 3074 or by facsimile to (03) 9460 2133 or by email to support@precisebackground.com. Precise Background Services reserves the right to charge a fee for searching for and providing access to your information. How to contact us To obtain a full copy of our Privacy Statement please contact Precise Background Services by any of the methods noted below. If you have any questions in relation to privacy, please contact Precise Background Services on (03)03 9460 2188 between 9.OOam and 5.OOpm, Monday to Friday. Alternatively, you can write to our Privacy Manager at PO Box 14 Thomastown VIC 3074, or by facsimile to (03) 9460 2133 or by email to support@precisebackground.com You may obtain further information on privacy matters by visiting our web site at www.precisebackground.com Precise Background Services Privacy Statement, December, 2007. Precise Background Services Pty Ltd ABN 67 115 925 641 Please go through and check that you have all your information, documentation and signed original copies prior to posting this to us. (Note: Please ensure you complete the Authority to conduct a criminal history check forms attached) Precise Background Services - Telstra Employment PACK 1 7

NATIONAL CRIMINAL HISTORY RECORD CHECK CONSENT TO OBTAIN PERSONAL INFORMATION GENERAL INFORMATION This Form is used by Precise Background Services so as to obtain a National Criminal History Check with your consent and for purposes which have been explained to you. It is important from the outset that if you are unclear as to why this request is being made or how the information that is obtained will be used then you should seek clarification before proceeding. Unless statutory obligations require otherwise, the information provided on this Form will not be used without your prior consent for any purpose other the reason for which is has been requested. CRIMINAL HISTORY RECORD CHECK Information extracted from the Form will be forwarded to the CrimTrac Agency, other Australian police services or other law enforcement agencies for checking action. By signing the Form you are providing your consent to these agencies: a) disclosing criminal history information that pertains to you from their own records to Precise Background Services and their client; and/or b) accessing their records to obtain criminal history information that in turn will be disclosed to Precise Background Services and their client. Such criminal history information may include outstanding charges, and criminal convictions/findings of guilt recorded against you that may be disclosed according to the laws of the relevant jurisdiction and, in the absence of any laws governing the release of that information, according to the relevant jurisdiction's information release policy. It is usual practice for an applicant's personal information to be disclosed to Australian police services for them to use for their respective law enforcement purposes including the investigation of any outstanding criminal offences. SPENT CONVICTIONS SCHEMES Victoria Police Policy - Victorian Records For the purposes of employment, voluntary work or occupational licensing/registration, police may restrict the release of a person's police record according to the police "Information Release Policy." If you have a police record the "Information Release Policy" may take into account the age of the police record and the purpose for which the information is being released. If ten years have elapsed since you were last found guilty of an offence, police will, in most instances, advise that you have no disclosable court outcomes. However, a record over ten years may be released:. if it includes a term of imprisonment longer than thirty months;. if it includes a serious, violent or sexual offence and the records check is for the purpose of working with; children, elderly people or disabled people;. if it is in the interests of crime prevention or public safety. Findings of guilt without conviction and good behaviour bonds may be released. Recent charges or outstanding matters under investigation that have not yet gone to court may also be released. Other Australian police services Where a criminal history record with another Australian police service has been obtained, any relevant legislation (and/or release policy) affecting that police service will be applied before that record is released. Under various pieces of Commonwealth, State and Territory legislation a person has the right, in particular circumstances or for a particular purpose, to not disclose certain convictions/findings of guilt over a certain age. Such convictions (widely referred to as "spent" or "rehabilitated" convictions) will not be released unless the records check is for the applicant's personal information only and provided that this is in accordance with relevant legislation (and/or release policy). Please contact individual police services directly for further information about their release policies and any legislation that affects them. Precise Background Services - Telstra Employment PACK 1 8

ADDITIONAL INFORMATION FROM TELSTRA PURPOSE Your criminal history records are being checked as part of Telstra's standard recruitment process for the role for which you have applied. Your employment with Telstra is subject to and conditional upon the results of a National Criminal History Check being received and assessed to the satisfaction of Telstra. Telstra will assess each candidate on their merit. The existence of a criminal record does not mean that you will be automatically assessed as being unsuitable for employment with Telstra. We encourage you to accurately complete this form to the best of your knowledge and ability. PRIVACY Your Personal information (including the results of the National Criminal Records Check) obtained by Telstra in order to assess your application will be handled in accordance with Telstra's Privacy Policy. You may obtain a copy of this policy from Telstra's website at http://www.telstra.com.au/privacy/index.html. In the course of considering your application, Telstra may use your personal information to verify your credentials and to collect additional personal information by contacting former employers or referees identified by you in the application process. If you are unsuccessful in this application, your personal information will be kept by Telstra for 12 months and may be considered for future positions. You may seek access to your personal information by contacting Telstra on 1800 039 059 (except in certain situations allowed by law). If you have any questions or require clarification about how your personal information will be used, please speak to your Telstra recruitment contact. PROVISION OF FALSE OR MISLEADING INFORMATION On this form you are asked to disclose whether you are the subject of any criminal charge(s) still pending before a Court, or whether you have been the subject of any conviction(s) or finding(s) of guilt before a Court. You are asked to certify that the personal information you have provided on this form is correct. If it is subsequently discovered, for example as a result of a check of police records, that you have provided false or misleading information, Telstra may decide that you are unsuitable for employment at that point. You should note that the existence of a record does not mean that you will be assessed automatically as being unsuitable for employment. It is in your interest to provide full and frank details in the form. Acknowledgement by candidate 1. I acknowledge that my personal information is being obtained for the purpose of conducting a criminal history check as part of Telstra's standard recruitment process for the role for which I have applied; and 2. I certify that I have fully completed this form, and the personal information I have provided is true and correct. Name: Signature: Date / / Precise Background Services - Telstra Employment PACK 1 9

(BLOCK LETTERS and in BLACK INK) STAFF-IN-CONFIDENCE (when completed) CONSENT TO OBTAIN PERSONAL INFORMATION FORM (NO EXCLUSION) I, hereby: Family Name (Current) Given Names (Current) 1. acknowledge that I have read the Spent Convictions Schemes section of the Information sheet and understand that Spent Convictions legislation (however described) in the Commonwealth and many States and Territories protects "spent convictions" from disclosure; 2. understand that the position for which I am being considered is in a category for which NO exclusion has been granted from the application of the Spent Convictions legislation; 3. have fully completed this Form, and the personal information I have provided in it relates to me, contains my full name and all names previously used by me, and is correct; and 4. consent to Precise Background Services disclosing personal information about me from to the CrimTrac Agency and the Australian police services; 5. consent to: (i) the CrimTrac Agency disclosing personal information about me to the Australian police services; (ii) the Australian police services disclosing, from their records, details of convictions and outstanding charges, including findings of guilt or the acceptance of a plea of guilty by a court, that can be disclosed in accordance with the laws of the Commonwealth, States and Territories and, in the absence of any laws governing the disclosure of this information, disclosing in accordance with the policies of the police service concerned; (iii) the CrimTrac Agency providing the information disclosed by the Australian police services to Precise Background Services in accordance with the laws of the Commonwealth; and (iv) Precise Background Services disclosing personal information about me to Telstra to assess my suitability in relation to my employment; and 6. acknowledge that any information provided by me on this Form, or by the Australian police services, may be taken into account by Telstra in assessing my suitability for the <specify position/entitlement> for which I am applying Signature Date / / Note: The information you provide on this Form, and which the CrimTrac Agency provides to Precise Background Services on receipt of the Form, will be used only for the purpose stated above unless statutory obligations require otherwise. PBS Office Use Only - Request Submitted by: Telstra Careers Centre [ ] Telstra Business Unit Direct [ ] Recruitment Agency [ ] Name: Phone: Email: Business Unit: Requisition No: Cost Centre No: Precise Background Services - Telstra Employment PACK 1 10

STAFF-IN-CONFIDENCE (when completed) PERSONAL INFORMATION NAMES BY WHICH I AM, OR EVER HAVE BEEN, KNOWN (including changes by Deed Poll): 1. Surname 2. Surname Given Names Given Names SEX: M F DATE OF BIRTH: / / (Please Circle) Day Month Year PLACE OF BIRTH: PHONE NUMBER: PASSPORT NUMBER: PASSPORT COUNTRY: DRIVER'S LICENCE NUMBER: STATE/TERRITORY: Permanent Residential Address over Last Five Years If full details of previous addresses are unavailable details of town(s) and state(s) will suffice. Attach list if insufficient room. Current If actual dates are unavailable, details of year of residence will suffice Period of residence / / to / / / / to / / / / to / / Criminal charges, convictions or pecuniary penalties If you answer YES to any of the following questions, please provide full details of the criminal charges, convictions, or pecuniary penalties (including year, term of imprisonment and any penalties, findings of guilt or other charges made). If necessary, you should attach a separate page. (i) Are you the subject of any traffic violations, criminal or traffic charges (not including parking infringements) still pending before a court? YES NO If "Yes", provide details (ii) Do you have any adult convictions or findings of guilt which are LESS THAN 10 years old or any juvenile convictions or findings of guilt which are LESS THAN 5 years old? YES NO If "Yes", provide details (iii) Do you have any adult convictions or findings of guilt which are OVER 10 years old (or 5 years for juvenile convictions or findings of guilt) where the sentence imposed was imprisonment for a period GREATER THAN 30 months? YES NO If "Yes", provide details Precise Background Services - Telstra Employment PACK 1 11

Precise Background Services - Telstra >> '100 Point Check' Validation Check List 1. Primary Documents Available Points per Item 70 Only one form of identification accepted from this category Points Scored n Birth Certificate n International Travel Document n A Current Passport n Expired Passport which has not been cancelled and was current within the preceding 2 years n Citizenship Certificate 2. Secondary Documents Available Points per Item 40 70 Only one form of identification accepted from this category Points Scored n Australian Driver's Licence / Permit n Public Service ID Card n Tertiary Student ID Card n Social Security Benefits Card n Trade Certificate / Licence 3. Tertiary Documents Available Points per Item 35 Only one form of identification accepted from this category Points Scored n Reference from current employer, or previous employer within the last 2 years n A Rating Authority (e.g. Land / Water / Service Rates) 4. Supplementary Documents Available Points per Item 25 Only one form of identification accepted from this category Points Scored n Advice from Telecommunications Provide (e.g. Account / Listing) n Credit Card / Medicare Card / Health Care Provider Card n Records of a Primary / Secondary / Tertiary educational institution attended within last 10 years n Records of professional or trade association membership 5. Total Points n Points must equal or exceed a total of 100 points Total Points Scored 6. OR Recent Arrival in Australia 70 n A Current Passport n Immediately before the person most recently arrived in Australia, the person was not ordinarily resident in Australia and, the signatory has been in Australia for less than 6 weeks. Sighted 7. Manager Declaration 70 I declare that I have completed the 100 Point Check Validation Checklist as appropriate of the relevant documents. Signature of Manager Date Print Manager s Name Precise Background Services - Telstra Employment PACK 1 12