CERTIFICATION AND RELEASE: I certify that I have read and understand the application note on page one of this form
and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best
of my knowledge and belief. I understand that any false information, omissions, or misrepresentation of facts called for in
this application may result in rejection of my application or discharge at any time during my employment. I authorize the
company and/or its agents, including consumer reporting bureaus, to verify any information including, but not limited to,
criminal history and motor vehicle driving records. I authorize all persons, schools, companies, and law enforcement
authorities to release any information concerning my background and hereby release any said persons, schools, companies,
and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand
that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to drug
testing to detect the use of illegal drugs prior to and during employment.