"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed,
falsified statements on this application sl1all be grounds for dismissal.

I authorize Investigation of all statements contained herein and the references and employers listed above to give you any and all information
concerning rny previous employment and any pertinent information they may have, personal or otherwise, and release the
company from all liability for any damage that may result from utilization of such information.

! also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any
specified period of tirne, or to rnake any agreement contrary to the foregoing, unless it is In writing and signed by an authorized company
representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with
Disabilities Act (ADA) and other relevant federal and state laws.

I understand that a consumer credit report or criminal records check may be necessary prior to my employment II such reports are
required, i understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these
reports and will also obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit
history or conviction will not automatically result in disqualification from employment"

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete
the required employment ellg1bllity verification document form upon hire.