NOTICE AND ACKNOWLEDGMENT

[IMPORTANT -- PLEASE READ CAREFULLY BEFORE SIGNING ACKNOWLEDGMENT]

NOTICE REGARDING BACKGROUND INVESTIGATION
Employer (“the Company”) may obtain information about you from a consumer reporting agency for employment purposes. Thus, you may be the subject of a
“consumer report” and/or an “investigative consumer report” which may include information about your character, general reputation, personal characteristics, and/or
mode of living, and which can involve personal interviews with sources such as your neighbors, friends, or associates. These reports may be obtained at any time
after receipt of your authorization and, if you are hired, throughout your employment. Credit history will only be requested where such information is substantially
related to the duties and responsibilities of the position for which you are applying. You have the right, upon written request made within a reasonable time after
receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report. Please be advised that the nature and scope of the most
common form of investigative consumer report obtained with regard to applicants for employment is an investigation into your education and/or employment history
conducted by Global HR Research, 9530 Marketplace Road, Suite 301, Fort Myers, FL 33912, Office: (239) 274-0048, Toll Free: 1-800-790-1205, website:
www.globalhrresearch.com or another outside organization. The scope of this notice and authorization is all-encompassing, however, allowing Employer to obtain
from any outside organization all manner of consumer reports and investigative consumer reports now and, if you are hired, throughout the course of your
employment to the extent permitted by law. As a result, you should carefully consider whether to exercise your right to request disclosure of the nature and scope of
any investigative consumer report.

New York and Maine applicants or employees only: You have the right to inspect and receive a copy of any investigative consumer report requested by the
Company by contacting the consumer reporting agency identified above directly. You may also contact the Company to request the name, address and telephone
number of the nearest unit of the consumer reporting agency designated to handle inquiries, which the Company shall provide within 5 days.
New York applicants or employees only: Upon request, you will be informed whether or not a consumer report was requested by the Company, and if such report
was requested, informed of the name and address of the consumer reporting agency that furnished the report.

Oregon applicants or employees only: Information describing your rights under federal and Oregon law regarding consumer identity theft protection, the storage and
disposal of your credit information, and remedies available should you suspect or find that the Company has not maintained secured records is available to you upon
request.
Washington State applicants or employees only: You also have the right to request from the consumer reporting agency a written summary of your rights and
remedies under the Washington Fair Credit Reporting Act.

ACKNOWLEDGMENT AND AUTHORIZATION

I acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT
REPORTING ACT and certify that I have read and understand both of those documents. I hereby authorize the obtaining of “consumer reports” and/or “investigative
consumer reports” at any time after receipt of this authorization and, if I am hired, throughout my employment. To this end, I hereby authorize, without reservation,
any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or
insurance company to furnish any and all background information requested by Global HR Research, another outside organization acting on behalf of Employer,
and/or Employer itself. I agree that a facsimile (“fax”), electronic or photographic copy of this Authorization shall be as valid as the original.
Minnesota and Oklahoma applicants or employees only: Please check this box if you would like to receive a copy of a consumer report if one
is obtained by the Company.

California applicants or employees only: By signing below, you also acknowledge receipt of the NOTICE REGARDING BACKGROUND
INVESTIGATION PURSUANT TO CALIFORNIA LAW. Please check this box if you would like to receive a copy of an investigative consumer
report or consumer credit report if one is obtained by the Company at no charge whenever you have a right to receive such a copy under
California law.

_____________ ___________________________________________________________
DATE PRINT NAME (First, Middle, Last)
_________________________________________________
SIGNATURE OF EMPLOYEE OR PROSPECTIVE EMPLOYEE
___________________________________________
SOCIAL SECURITY NUMBER
___________________________________________
Date of Birth (For Background Purposes Only)
___________________________________________
Driver License Number State
Current Address:

_____________________________________________________________________________________________________________
Previous Addresses (Last 7 years):
_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

Any other names I have been known by (including maiden name):

_____________________________________________________________________________________________________________
Para informacion en espanol, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection
Bureau, 1700 G Street N.W., Washington, DC 20552.

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of
consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and
specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history
records). Here is a summary of your major rights under the FCRA. For more information, including information about
additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G
Street N.W., Washington, DC 20552.

• You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of
consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against
you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.

• You have the right to know what is in your file. You may request and obtain all the information about you in the files of a
consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include
your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
• a person has taken adverse action against you because of information in your credit report;
• you are the victim of identity theft and place a fraud alert in your file;
• your file contains inaccurate information as a result of fraud;
• you are on public assistance;
• you are unemployed but expect to apply for employment within 60 days.

In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit
bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for
additional information.

• You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on
information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or
distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you
will receive credit score information for free from the mortgage lender.

• You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is
incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute
is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.

• Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate,
incomplete, or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer
reporting agency may continue to report information it has verified as accurate.

• Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting
agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years
old.

• Access to your file is limited. A consumer reporting agency may provide information about you only to people with a
valid need -- usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA
specifies those with a valid need for access.

• You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out
information about you to your employer, or a potential employer, without your written consent given to the employer.
Written consent generally is not required in the trucking industry. For more information, go to
www.consumerfinance.gov/learnmore.

• You may limit “prescreened” offers of credit and insurance you get based on information in your credit report. Unsolicited
“prescreened” offers for credit and insurance must include a toll-free phone number you can call if you choose to remove
your name and address from the lists these offers are based on. You may opt out with the nationwide credit bureaus at 1-
888-5-OPTOUT (1-888-567-8688).

• You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a
furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.

• Identity theft victims and active duty military personnel have additional rights. For more information, visit
www.consumerfinance.gov/learnmore.
States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have
more rights under state law. For more information, contact your state or local consumer protection agency or your state
Attorney General. For information about your federal rights, contact:

TYPE OF BUSINESS: CONTACT:

1.a. Banks, savings associations, and credit unions with total assets a. Consumer Financial Protection Bureau
of over $10 billion and their affiliates. 1700 G Street, N.W.
Washington, DC 20552
b. Such affiliates that are not banks, savings associations, or credit
unions also should list, in addition to the CFPB: b. Federal Trade Commission: Consumer
Response Center – FCRA
Washington, DC 20580
(877) 382-4357
2. To the extent not included in item 1 above:

a. National banks, federal savings associations, and federal a. Office of the Comptroller of the Currency
branches and federal agencies of foreign banks Customer Assistance Group
1301 McKinney Street, Suite 3450
b. State member banks, branches and agencies of foreign banks Houston, TX 77010-9050
(other than federal branches, federal agencies, and Insured State
Branches of Foreign Banks), commercial lending b. Federal Reserve Consumer Help Center
companies owned or controlled by foreign banks, and P.O. Box 1200
organizations operating under section 25 or 25A of the Federal Minneapolis, MN 55480
Reserve Act
c. FDIC Consumer Response Center
c. Nonmember Insured Banks, Insured State Branches of Foreign 1100 Walnut Street, Box #11
Banks, and insured state savings associations Kansas City, MO 64106

d. Federal Credit Unions d. National Credit Union Administration

Office of Consumer Protection (OCP)
Division of Consumer Compliance and Outreach (DCCO)
1775 Duke Street
Alexandria, VA 22314
3. Air carriers Asst. General Counsel for Aviation
Enforcement & Proceedings
Aviation Consumer Protection Division
Department of Transportation
1200 New Jersey Avenue, S.E.
Washington, DC 20590
4. Creditors Subject to Surface Transportation Board Office of Proceedings, Surface Transportation
Board
Department of Transportation
395 E Street, S.W.
Washington, DC 20423
5. Creditors Subject to the Packers and Nearest Packers and Stockyards
Stockyards Act, 1921 Administration area supervisor

6. Small Business Investment Companies Associate Deputy Administrator for Capital

Access
United States Small Business Administration
409 Third Street, S.W., 8th Floor
Washington, DC 20416
7. Brokers and Dealers Securities and Exchange Commission
100 F Street, N.E.
Washington, DC 20549
8. Federal Land Banks, Federal Land Bank Associations, Federal Farm Credit Administration
Intermediate Credit Banks, and Production Credit Associations 1501 Farm Credit Drive
McLean, VA 22102-5090
9. Retailers, Finance Companies, and All Other Creditors Not Listed FTC Regional Office for region in which the
Above creditor operates or Federal Trade Commission: Consumer
Response Center – FCRA
Washington, DC 20580
(877) 382-4357