I CERTIFY
AFFIDAVIT PLEASE READ EACH STATEMENT CAREFULLY BEFORE ACCEPTING
I certify that all information provided on this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may justify my dismissal if discovered at a later date. I also certify that I am submitting this application for the sole reason of seeking employment for myself and no other alternate reason.
I understand that the employer may request an investigative consumer report from a consumer reporting agency. This report may include information as to my character, reputation, personal characteristics and mode of living obtained from interviews with neighbors, friends, former employers, schools and others. I understand I have a right to make a written request within a reasonable time for the disclosure of the name and address of the consumer reporting agency so that I may obtain a complete disclosure of the nature and scope of the investigation.
I authorize the investigation of any or all statements contained in this application and also authorize any person, school, current employer (except as previously noted), past employers and organizations named in this application to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and/or organizations from any legal liability in making such statement, and release the prospective employer from any legal liability in connection with its consideration of such statements.
I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to perform the essential job functions of the position for which I am applying.
I understand this application or subsequent employment does not create a contract of employment nor guarantee employment for any definite period of time. If employed, I understand that I have been hired at the will of the employer and my employment may be terminated at any time, with or without cause and with or without notice.
I have read, understand, and consent to these statements.
NOTICE TO APPLICANT OF INVESTIGATIVE CONSUMER REPORT
I understand that Union Bank & Trust Company may request an investigative consumer report from a consumer reporting agency for employment purposes, including the consideration of my job application. This report may include information as to my character, reputation, personal characteristics and mode of living. The investigation may include a check on , among other things, my credit record, criminal history, military record, employment record and driving record. Information may be obtained through review of credit records, review of records of public agencies, including criminal courts, and through personal interviews with my neighbors, friends, or others with whom I am associated or acquainted, and with former employers, schools, and others. I understand that I have the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of this investigation.
I authorize Union Bank & Trust Company to conduct the investigation referred to above, or to have others conduct it, and I authorize Union Bank & Trust Company to obtain a consumer report on me as referred to above.
I also authorize current and former employers and others referred to above to provide relevant information and opinions about me and to release and discuss all records and information such from and individuals may have about me. I release such employers and other persons who may give or receive information pursuant to this authorization from any legal liability and from any and all claims of any kind.
The above statements are given freely and voluntarily.
UNION BANK & TRUST COMPANY APPLICANT'S CRIMINAL HISTORY DISCLOSURE
Information provided by you in this disclosure WILL NOT automatically bar you from employment or volunteer work with Union Bank, but will be considered in view of all relevant circumstances. Any falsification, misrepresentation or incompleteness in this disclosure is alone grounds for disqualification. Please read the disclosure carefully and provide an explanation should you have any questions on any statement.
