1. I hereby authorize and request any and all of my former employers and any other person, firm, or corporation to furnish any and all information concerning my personal background and I hereby release such employer, other person, firm, or corporation from any and all liability by reason of furnishing the requested information. I understand that in connection with this application, an investigative consumer report may be requested whereby information is obtained through personal interviews with my neighbors, friends, or associates or others with whom I am acquainted or who may have knowledge with respect to my character, general reputation, personal characteristics, and mode of living, and hereby authorize the procurement of any such report. I understand that upon my request, I have the right to know if any such report was requested and if so, the name and address of the reporting agency that furnished such reports and that upon request I may receive a copy of such report from the reporting agency.
2. I understand that $53.00 for the state-required background check will be deducted from my final paycheck if my employment is terminated within the first year.
3. I understand that, if employed, any misrepresentation or omission of facts in this application is cause for dismissal and that my employment is for no definite period of time and I may, regardless of the date of payment of my wages and salary, be terminated at any time without cause.
