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BACKGROUND INVESTIGATION GROUP

SAUDI ARAMCO CORPORATE SECURITY SERVICES DIVISION

BACKGROUND SCREENING FORM

Failure to provide all the requested information, documentation and CLEAR copies, will result in delays
in your background investigation processing.

Please COMPLETE the provided Background Screening Form (BSF-1) completely and
accurately. Attach additional pages (with your name on each page) if necessary.
Please note page (5) of the BSF-1, requires (2 adult) witness signatures, or
If you have lived, worked, or been educated in North America or Europe, a Notary
Public Seal is required in addition to your signature.

BACKGROUND SCREENING CHECKLIST

Required documents in the checklist below are to be included in the return package:

1. A clear photocopy of the picture page of your Passport, or Government issued Identification
2. If you are applying for full time Saudi Aramco Employment: a copy of your
marriage certificate (Contractors are exempt from this requirement)

3. Copies of highest academic qualifications (Clear copy of your University Diplomas

and transcripts, front and back).

4. Copies of professional licenses or certificates that pertain to your profession.

5. Clear copy of your resume

6. Saudi Aramco application (if applicable)

7. Background Screening Form (BSF-1) signed and dated within the current six
months.

Please complete this form, attach the requested clear copy documents, and provide them to
your recruiter or a Saudi Aramco Staffing Services Division representative so they may be
forwarded to the Saudi Aramco Background Investigation Group (BIG).
SAUDI ARAMCO BACKGROUND SCREENING FORM BSF-1 (Apr.2010.v6) Page 1 of 5
Additional information is being requested to assist in the Background Screening, the results of which must be satisfactory to Saudi Aramco. Requested
information marked with an asterisk (*) and will be used for identification purposes only.

* To add ADDITIONAL INFORMATION, please attach page(s) with your name on each page, and identify the specific questions you are answering
1. PERSONAL INFORMATION
ARAMCO BADGE NUMBER
FULL NAME: (LAST) (FIRST) (MIDDLE)
(IF APPLICABLE)

N/A
OTHER NAMES (MARRIED, FORMER MARRIED, NICKNAME):
*PLACE OF BIRTH CITY STATE/PROVINCE COUNTRY

*SOCIAL SECURITY OR NATIONAL ID NUMBER *PASSPORT NUMBER *PASSPORT COUNTRY OF ISSUE EXPIRATION DATE (MM/DD/YYYY)

*DRIVERS LICENSE NUMBER *COUNTRY OF ISSUE *EXPIRATION DATE (MM/YYYY)

HOME PHONE: MOBILE PHONE: OTHER:

EMAIL ADDRESS(ES) NATIONAL CITIZENSHIP(S) AND STATUS

1

PRESENT ADDRESS: NUMBER/ STREET CITY STATE/PROVINCE COUNTRY POSTAL CODE

FROM(MM/YYYY): TO(MM/YYYY):
LIST PREVIOUS ADDRESSES FOR LAST 7 YEARS (Attach pages if needed) INDIAN and PAKISTANI candidates must place "permanent" address on last line
FROM (MM/YYYY) TO (MM/YYYY) ADDRESS: NUMBER/STREET CITY STATE COUNTRY POSTAL CODE

Permanent Address line - Indian and Pakistani Candidates Only - MUST be filled out

*MOTHER’S FULL NAME AND MAIDEN NAME *FATHER’S FULL NAME

CANDIDATE MARITAL STATUS:

MARRIED SINGLE DIVORCED SEPARATED

DATE OF MARRIAGE(S)
PLACE OF MARRIAGE(S): CITY COUNTY STATE/PROVINCE COUNTRY
 1. PERSONAL INFORMATION (CONTINUED) Page 2 of 5
FULL NAME OF SPOUSE(S):

DESCRIBE PAST OR PRESENT

ILLEGAL USE OF THE FOLLOWING: NEVER RARELY OCCASIONALLY REGULARLY

MARIJUANA
HASHISH
COCAINE
METHAMPHETAMINE
PRESCRIPTION DRUGS
OTHER ILLEGAL DRUGS
DESCRIBE YOUR ALCOHOL USE

HAVE YOU EVER BEEN INVOLVED IN ANY ACT OF WORK PLACE VIOLENCE? YES NO
IF YES, PLEASE EXPLAIN: N/A

HAVE YOU EVER BEEN TERMINATED OR RESIGNED IN LIEU OF TERMINATION FROM ANY JOB? YES NO

IF YES, PLEASE EXPLAIN: N/A

2. LEGAL ACTIONS
HAVE YOU EVER BEEN CONVICTED OF A CRIMINAL OFFENSE? YES NO N/A
IF YES, PROVIDE DATE, LOCATION OF CHARGES, AND ALLEGED OFFENSE WITH EXPLANATION: Date:

DETAILS: N/A

NATURE OF OFFENSE: N/A IS THE CASE STILL PENDING? YES NO

DATE OF
SENTENCE:
N/A CONVICTION: N/A
LIST ANY TRAFFIC TICKETS (DATE(S)/OFFENSE/LOCATION) YOU HAVE RECEIVED IN THE LAST THREE (3) YEARS:
N/A

HAVE YOU EVER BEEN NAMED AS A PARTY IN ANY CIVIL COURT ACTION? YES NO
HAVE YOU FILED FOR BANKRUPTCY WITHIN THE LAST 7 YEARS? YES NO
IF YES, EXPLAIN IN DETAIL, INCLUDING DATE, LOCATION, AND COURT CASE NUMBER(S):
N/A

3. EMPLOYMENT
PROVIDE EMPLOYMENT HISTORY FOR AT LEAST THE LAST 7 YEAR PERIOD N/A = NOT APPLICABLE

*PLEASE INDICATE IF WE MAY CONTACT YOUR CURRENT EMPLOYER FOR A REFERENCE. Yes No N/A
IF YOU ANSWERED "NO", ATTACH A PAY SLIP(S) CONTRACT, OR OTHER OFFICAL DOCUMENTATION TO PROVE CURRENT EMPLOYMENT

DO NOT CONTACT MY CURRENT EMPLOYER UNTIL:

1. CURRENT EMPLOYER/NAME STREET CITY STATE/PROVINCE COUNTRY

COMPANY/EMPLOYER PHONE NUMBER YOUR OCCUPATION/JOB TITLE EMPLOYMENT PERIOD (MM/DD/YYYY)

FROM: TO:
DEPARTMENT NAME SUPERVISOR’S NAME CONTACT NUMBER FOR SUPERVISOR

YOUR EMPLOYMENT STATUS: COMPANY ID NUMBER REASON FOR LEAVING

TEMPORARY PERMANENT CONTRACT
 3. EMPLOYMENT (CONTINUED) Page 3 of 5
2. EMPLOYER/COMPANY NAME STREET CITY STATE/PROVINCE COUNTRY

COMPANY/EMPLOYER PHONE NUMBER YOUR OCCUPATION/JOB TITLE EMPLOYMENT PERIOD (MM/DD/YYYY)

FROM: TO:
DEPARTMENT NAME SUPERVISOR’S NAME CONTACT NUMBER FOR SUPERVISOR

YOUR EMPLOYMENT STATUS: COMPANY ID NUMBER REASON FOR LEAVING

TEMP PERMANENT CONTRACT
3. EMPLOYER/COMPANY NAME STREET CITY STATE/PROVINCE COUNTRY

COMPANY/EMPLOYER PHONE NUMBER YOUR OCCUPATION/JOB TITLE EMPLOYMENT PERIOD (MM/DD/YYYY)

FROM: TO:
DEPARTMENT NAME SUPERVISOR’S NAME CONTACT NUMBER FOR SUPERVISOR

YOUR EMPLOYMENT STATUS: COMPANY ID NUMBER REASON FOR LEAVING

TEMP PERMANENT CONTRACT
4. EMPLOYER/COMPANY NAME STREET CITY STATE/PROVINCE COUNTRY

COMPANY/EMPLOYER PHONE NUMBER YOUR OCCUPATION/JOB TITLE EMPLOYMENT PERIOD (MM/DD/YYYY)

FROM: TO:
DEPARTMENT NAME SUPERVISOR’S NAME CONTACT NUMBER FOR SUPERVISOR

YOUR EMPLOYMENT STATUS: COMPANY ID NUMBER REASON FOR LEAVING

TEMP PERMANENT CONTRACT
5. EMPLOYER/COMPANY NAME STREET CITY STATE/PROVINCE COUNTRY

COMPANY/EMPLOYER PHONE NUMBER YOUR OCCUPATION/JOB TITLE EMPLOYMENT PERIOD (MM/DD/YYYY)

FROM: TO:
DEPARTMENT NAME SUPERVISOR’S NAME CONTACT NUMBER FOR SUPERVISOR

YOUR EMPLOYMENT STATUS: COMPANY ID NUMBER REASON FOR LEAVING

TEMP PERMANENT CONTRACT
6. EMPLOYER/COMPANY NAME STREET CITY STATE/PROVINCE COUNTRY

COMPANY/EMPLOYER PHONE NUMBER YOUR OCCUPATION/JOB TITLE EMPLOYMENT PERIOD (MM/DD/YYYY)

FROM: TO:

DEPARTMENT NAME SUPERVISOR’S NAME CONTACT NUMBER FOR SUPERVISOR

YOUR EMPLOYMENT STATUS: COMPANY ID NUMBER REASON FOR LEAVING

TEMP PERMANENT CONTRACT
PROVIDE EXPLANATIONS FOR ALL TIME PERIODS NOT ACCOUNTED FOR OF EMPLOYMENT FOR THE LAST 7 YEARS. PROVIDE NAME, ADDRESS AND PHONE
NUMBER(S) OF INDIVIDUALS AND/OR DOCUMENTS TO VERIFY YOUR ACTIVITIES DURING THIS PERIOD.
 4. EDUCATION INFORMATION - Add extra page(s) if needed Page 4 of 5
1.Provide copy of highest degree/diploma/certificate attained and transcripts (mark sheets).
2.India candidates must provide diploma registration/hall ticket/degree number.

LIST RELEVANT ACADEMIC DEGREE(S), CERTIFICATE(S), OR DIPLOMA(S) ATTAINED - MUST PROVIDE COPIES
NAME OF INSTITUTION TYPE OF DEGREE, DIPLOMA OR CERTIFICATION RECEIVED

INSTITUTION ADDRESS: STREET CITY STATE/PROVINCE COUNTRY

INSTITUTION PHONE NUMBER DATES ATTENDED DATE DIPLOMA/CERTIFICATE RECEIVED

FROM (MM/DD/YYYY):
TO (MM/DD/YYYY): (MM/DD/YYYY):
STUDENT ID NUMBER REGISTRATION NUMBER FOR CERTIFICATION, DIPLOMA, DEGREE
(IF APPLICABLE), INDIA CANDIDATE REQUIREMENT:
(LIST OTHER RELEVANT DEGREE/DIPLOMA/CERTIFICATE BELOW)
NAME OF INSTITUTION TYPE OF DEGREE, DIPLOMA OR CERTIFICATION RECEIVED

INSTITUTION ADDRESS: STREET CITY STATE/PROVINCE COUNTRY

INSTITUTION PHONE NUMBER DATES ATTENDED DATE DIPLOMA/CERTIFICATE RECEIVED

FROM (MM/DD/YYYY):
TO (MM/DD/YYYY): (MM/DD/YYYY):
STUDENT ID NUMBER REGISTRATION NUMBER FOR CERTIFICATION, DIPLOMA, DEGREE
(IF APPLICABLE) INDIA CANDIDATE REQUIREMENT:
LIST RELEVANT, CURRENT CERTIFICATES, CERTIFICATIONS, AND LICENSES - MUST PROVIDE COPY(S)
PROFESSIONAL CERTIFICATION/LICENSING ORGANIZATION CERTIFICATION/LICENSE NAME REGISTRATION/LICENSE NUMBER

PROFESSIONAL CERTIFICATION/LICENSING ORGANIZATION CERTIFICATION/LICENSE NAME REGISTRATION/LICENSE NUMBER

PROFESSIONAL CERTIFICATION/LICENSING ORGANIZATION CERTIFICATION/LICENSE NAME REGISTRATION/LICENSE NUMBER

HAVE YOU EVER HAD A PROFESSIONAL LICENSE, CERTIFICATION, OR PROFESSIONAL MEMBERSHIP REVOKED, SUSPENDED, OR TERMINATED?
YES NO IF YES, NAME THE CERTIFICATE, LICENSE, OR PROFESSIONAL MEMBERSHIP AND EXPLAIN BELOW:
N/A

HAVE YOU EVER BEEN PLACED ON PROBATION OR DISCIPLINED BY A PROFESSIONAL ORGANIZATION? YES NO
IF YES, NAME THE ORGANIZATION AND EXPLAIN THE CIRCUMSTANCES IN DETAIL:
N/A

5. DECLARATION - PLEASE RECHECK ALL INFORMATION ON THIS FORM AND SIGN BELOW
“I hereby certify that all facts provided herein are complete and accurate. I understand that any falsehood, misrepresentation or
omission of any fact by me, whether submitted orally or in writing and pertaining to the information herein, will be sufficient cause for
cancellation by the Company of my application or for termination of my employment for cause.”

SIGNATURE:

PRINTED NAME: DATE (MM/DD/YYYY):

AUTHORITY TO RELEASE PERSONAL INFORMATION Page 5 of 5
I hereby authorize all persons, schools, companies, corporations, associations, groups, partnerships, professional
associations, government agencies, credit bureaus, bureaus of vital statistics, references, (provided or developed),
and law enforcement agencies to supply and release any information, including birth certificates to Saudi Aramco
any of their affiliates, subsidiaries, and/or authorized agents to conduct security screening inquiries.

I further authorize the procurement of a consumer credit report or other like documents and understand
the report may contain information on my background, mode of living, character, and personal reputation. I
further consent to the review and release of any information from my military records deemed necessary.
I understand the information requested may be obtained now or at any time in the future for the purpose
of performing a security clearance check for authorization to gain or to maintain access to the physical and
computer facilities of Saudi Aramco. Any information obtained shall be viewed and stored with all reasonable
care, and will not be released outside the entities listed above or its subsidiaries unless, it is required to do so
in compliance with legal process.
I acknowledge and consent that the information disclosed in this form will be sent outside my country of residence
and specifically to Saudi Arabia. I further acknowledge that the information disclosed in this form will be processed
in Saudi Arabia. I understand that this is a condition to Saudi Aramco's review of my application for employment.

I hereby voluntarily affixed my signature and represent this document to be an original. I further acknowledge,
consent and agree that photocopies of this Release form may be made and used as if they were original copies.

*ALL NORTH AMERICAN CANDIDATES MUST HAVE A NOTARY SEAL

ALL OTHER CANDIDATES - SIGNATURE REQUIRED WITH 2 WITNESSES, OR CANDIDATE SIGNATURE AND NOTARY SEAL

CANDIDATE SIGNATURE (below): PRINTED NAME(below): DATE (MM/DD/YYYY) (below):

WITNESS SIGNATURE(below): PRINTED NAME(below): DATE (MM/DD/YYYY) (below):

WITNESS SIGNATURE(below): PRINTED NAME(below): DATE (MM/DD/YYYY) (below):

Before me, the undersigned authority, the person named,

(NOTARY - PRINT NAME) (PRINT CANDIDATE NAME HERE)

appeared in person, and signed this document in my presence

Given Under My Hand and Seal: This day of , 20 . (Notary Stamp/Seal Here)

Notary Signature: Expiration Date:

MM/DD/YYYY