In connection with my application for employment (including contract for service) with you, I understand that inquiries are to be made on myself, including consumer credit, criminal convictions, motor vehicle, and other reports. These reports may include information as to my character, work, habits, performance, and experience, along with reasons for termination of past employment from previous employers. Further, I understand that you will be requesting information from various Federal, State, and other agencies that maintain records concerning my past activities relating to my driving, credit, criminal, civil, education, and police arrest records in any criminal justice agency in the US, and other experiences. If hired, I understand periodic background checks may also be performed during my time of employment. The above information is for identification purposes only and will not be used to violate any state or federal equal opportunity laws.

I authorize without reservation any party or agency contacted by this employer to furnish the below-mentioned personal information.