I here by declare the information provided by me in this Application for Employment is true, correct and complete to the best of my knowledge. I understand that if employment, any misstatement or omission of fact on this application shall be considered cause for dismissal.

I authorize you to obtain an investigative consumer report containing information obtained through personal interviews with my neighbors, friends and acquaintances. This report, if obtained, may include information as to my character, general reputation, personal characteristics and mode of living. I understand I have the right to make request within a reasonable period to receive additional detailed information about the nature and scope of any investigation.