Please download the “BRAIN Personal Statement and Disclosure Authorization” file above (right click and download), complete and sign (fill & Sign on PDF viewer or physical signature) all pages, and upload the signed scan copies below.请下载上面的“BRAIN个人声明和披露授权”文件(右键单击并下载),填写并签署(在PDF查看器上填写并签署或物理签名)所有页面,并上传下面签名的扫描件。 Upon written request, you will be informed whether or not a Report was requested, and if such Report was requested, the nature and scope of any investigation, and the name and address of the consumer reporting agency to whom the request was made. You will be able to inspect and receive a copy of such Report by contacting such agency. If the Firm intends to make an adverse decision regarding your application to become a consultant to the Firm based, in whole or in part, on any Information from the Report, the Firm will provide you with a copy of any such Report prior to implementing such action. You acknowledge and agree that this authorization will remain on file and will serve as a continuing authorization for the Firm to conduct drug and other controlled substance testing and procure CRD registration records, Reports, or other screening and background checks, at any time during the term of your consulting agreement with the Firm根据书面要求,您将被告知是否要求提供报告,如果要求提供此类报告,任何调查的性质和范围,以及向其提出要求的消费者报告机构的名称和地址。您可以通过联系该机构来检查并收到此类报告的副本。如果公司打算根据报告中的任何信息,全部或部分对您担任公司顾问的申请做出不利决定,公司将在采取此类行动之前向您提供任何此类报告的副本。您承认并同意,此授权将保留在档案中,并将作为公司在您与公司签订咨询协议期间的任何时候进行药物和其他受控物质测试以及获取CRD注册记录、报告或其他筛查和背景调查的持续授权 By signing below you acknowledge your understanding that as part of the Firm’s background investigation, the Firm may obtain (including from outside vendors) a Report. You authorize the Firm, or its agents, to request that any and all of your business associates, landlords, federal, state and/or local government agencies, national credit bureaus, schools and any other parties furnish Information to the Firm or its agents. Moreover, you hereby release each such source of Information from any liability whatsoever resulting from the furnishing of such Information to the Firm or its agents. You further authorize the Firm tomake available to any prospective employer and/or to any federal, state or municipal agency anyInformation it may have concerning you.通过在下面签名,您承认您理解,作为公司背景调查的一部分,公司可能会获得(包括从外部供应商那里)一份报告。您授权公司或其代理人要求您的任何和所有商业伙伴、房东、联邦、州和/或地方政府机构、国家信用局、学校和任何其他方向公司或其代理提供信息。此外,您特此免除每个此类信息来源因向公司或其代理人提供此类信息而产生的任何责任。您进一步授权公司向任何潜在雇主和/或任何联邦、州或市政机构提供其可能掌握的有关您的任何信息。 By this document, the Firm discloses to you that a screening, background check, consumer report and/or investigative consumer report (“Report”) containing information concerning your criminal record, credit record, character, general reputation, personal characteristics, professional and educational background, and/or mode of living (“Information”), may be obtained in connection with your application to become a consultant to the Firm and also may be obtained for any purpose at any time during the term of your consulting agreement with the Firm. A Report may involve personal interviews with sources such as neighbors, friends, associates or others. In obtaining a Report, the Firm may review information regarding your conviction record, credit report and/or driving record (all to the extent allowed under applicable law), and/or receive transcripts, records and/or documents pertaining to your background, education, prior employment and/or employment performance, and/or to conduct and obtain the results of any required drug test, which shall only be obtained and conducted in accordance with applicable law.通过本文件,本所向您披露,在您申请成为本所顾问的过程中,可能会获得一份筛查、背景调查、消费者报告和/或调查消费者报告(“报告”),其中包含有关您的犯罪记录、信用记录、性格、一般声誉、个人特征、专业和教育背景和/或生活方式的信息(“信息”),也可能在您与本所签订的咨询协议期限内随时出于任何目的获得。报告可能涉及对邻居、朋友、同事或其他人的个人采访。在获取报告时,本所可以审查与我们的定罪记录、信用报告和/或驾驶记录有关的信息(在适用法律允许的范围内),和/或接收与您的背景、教育、先前就业和/或就业表现有关的成绩单、记录和/或文件,和/或者进行和获得任何所需的药物测试的结果,这些测试只能根据适用法律获得和进行。 Please upload national or local ID (or PAN card if a candidate in India) below. After a few days, you will receive notification by email and on the BRAIN dashboard that you are now a “Conditional Consultant”. After ~3 weeks, you should expect to receive a notification by email and on the BRAIN dashboard that your background check is complete and details of next steps to become a full WQ Brain Consultant.请在下面上传国家或地方身份证(如果候选人在印度,请上传PAN卡)。几天后,您将通过电子邮件和BRAIN仪表板收到通知,表示您现在是“有条件顾问”。大约3周后,您应该会收到电子邮件和BRAIN仪表板上的通知,告知您的背景调查已完成,以及成为WQ BRAIN顾问的下一步详细信息。 All information must be true and complete to the best of your knowledge and belief, and all of your responses must be in ENGLISH (only where instructed use local language). No section or field should be left blank. You are required to answer each question, unless a question does not apply to you (e.g. question is for certain countries only, question is for currently employed person only), in which case insert "Not Applicable" or "NA" . All information provided in this form is subject to verification by WorldQuant, LLC (the “Firm”) and/or its agents, and any falsification, misrepresentation or omission of fact in this form, or during the engagement process, may be cause for denial or termination of your consulting agreement with the Firm. Responses to various questions contained in this questionnaire (including, without limitation, the questions set forth in the Regulatory Questions section) are required in connection with the Firm’s obligations under the U.S. Investment Advisers Act of 1940, as amended and the U.S. Securities Act of 1933, as amended.据您所知和所信,所有信息必须真实完整,您的所有回复必须使用英语(仅在有指示的情况下使用当地语言)。任何部分或字段都不应留空。您需要回答每个问题,除非某个问题不适用于您(例如,该问题仅适用于某些国家,仅适用于当前在职人员),在这种情况下,请插入“不适用”或“NA”。本表格中提供的所有信息均须经WorldQuant,LLC(“公司”)和/或其代理人核实,本表格中或在聘用过程中对事实的任何伪造、虚假陈述或遗漏都可能导致您与公司的咨询协议被拒绝或终止。需要对本问卷中包含的各种问题(包括但不限于监管问题部分中提出的问题)作出回应,这些问题与公司在经修订的1940年《美国投资顾问法》和经修订的1933年《美国证券法》下的义务有关。 Please provide complete address history for the past five years in ENGLISH and LOCAL language. Please include all addresses in any location where you have resided for more than 1 month. Use the following spaces, as needed, beginning with the most recent.Address for the last five years (Street, City, State/Province, Postal Code)请用英语和当地语言提供过去五年的完整地址历史。请包括您居住超过1个月的任何地点的所有地址。根据需要使用以下空格,从最新空格开始。过去五年的地址(街道、城市、州/省、邮政编码)