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 will be grounds for immediate dismissal.

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

I also understand and agree that no representative of the company that has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and authorized 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 ADA (Americans with Disabilities Act) and any other relevant federal, state, or local laws.