I certify that I have read and understood all of this employment application. All information provided by me in support of my application is true and correct to the best of my knowledge. I voluntarily and knowingly authorize any former employer, person, firm, corporation, school or government agency, its officers, employees and agents to release any and all information to this company, its officers, employees and agents, or any other person or entity making a written or oral request for such information on behalf of this company.

I understand that the employment information requested may include, but is not necessarily limited to performance evaluations and reports, job descriptions, disciplinary reports, letters of reprimand, opinions and public record information regarding my suitability for employment. I understand that the inquiries are in compliance with 49 CFR §391.21 as part of the required safety history investigation. I also understand that all information provided by former employers will be kept confidential in a secure location and is only available to authorized persons as described in §391.53.

I understand and agree that the company may as part of its evaluation of my employment application, use reference checking services, interviews (by telephone or written correspondence) or other contact with my references and others who may know me or may know of information required in the safety history review and that a report of this information may be made to this company. I agree to furnish such additional information and authorization as may be required to complete the safety history review in a timely manner. I also understand that misrepresentation or omission of information or facts may result in the rejection of this application or my dismissal if I am hired. I understand that in accordance with §391.23 the company has taken all precautions reasonably necessary to ensure the accuracy of records provided to them I also understand that I have a right to review the information supplied by my previous employers and correct erroneous information. I understand that more information about this inquiry will be provided upon written request.

I understand that, as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks that are pertinent to the job. I agree to furnish such additional information and complete such examinations as may be required to complete my employment file. I also understand that if offered a job, it may be conditioned on the results of a physical examination and drug test. If hired, I agree to abide by all the rules and policies of the employer.

I recognize that a copy of this authorization and release is as valid as the original and should be considered as such.

This certifies that I am a genuine applicant for employment and this application is being submitted for the purpose of seeking employment with the employer and for no other reason. This also certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.