Symbii Legal Disclosures

I CERTIFY THAT ALL THE INFORMATION SUBMITTED IN THIS APPLICATION FORM OR IN MY RESUME, INTERVIEW, OR OTHER INFORMATION, IS TRUE AND COMPLETE AND THAT I HAVE NOT KNOWINGLY WITHHELD, NOR WILL I WITHHOLD, ANY INFORMATION THAT WOULD AFFECT MY APPLICATION FOR EMPLOYMENT. I UNDERSTAND THAT THE EMPLOYER IS UNDER NO OBLIGATION TO CONSIDER OR RECONSIDER THIS APPLICATION AT ANY TIME, AND THAT ACCEPTANCE OF MY APPLICATION DOES NOT CONSTITUE AN OFFER OF EMPLOYMENT. I UNDERSTAND THAT ANY UNTRUE STATEMENTS OR OMISSIONS IN THIS APPLICATION OR DURING THE INTERVIEW WILL BE JUST CAUSE FOR REVOCATION OF THE EMPLOYMENT OFFER OR DISMISSAL, REGARDLESS OF WHEN THE FALSIFICATION AND/OR OMISSION IS DISCOVERED. I ALSO UNDERSTAND AND AGREE THAT:

INQUIRIES MAY BE MADE WITH MY PREVIOUS EMPLOYERS OR OTHERS WHO MAY HAVE KNOWLEDGE OF ME. I AUTHORIZE ANY SUCH PERSON OR AGENCY TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT, INCLUDING BUT NOT LIMITED TO, AN ASSESSMENT OF MY JOB PERFORMANCE, ABILITY, AND FITNESS, AND/OR ANY OTHER INFORMATION THEY MAY HAVE, PERSONAL, OR OTHERWISE AND RELEASE ALL PARTIES FROM ANY AND ALL LIABILITIES, CLAIMS, OR DAMAGES THAT MAY DIRECTLY OR INDIRECTLY RESULT FROM FURNISHING SAME.

PRIOR TO MY BEGINNING WORK OR DURING MY EMPLOYMENT, EMPLOYER RESERVES THE RIGHT TO REQUIRE ANY LAWFUL FORM OF MEDICAL, DRUG, ALCOHOL, PSYCHOLOGICAL, CHARACTER, HONESTY, INTEGRITY, APTITUDE, SKILL, OR OTHER TESTS OR EXAMINATIONS.

THIS APPLICATION FOR EMPLOYMENT REPRESENTS THE ENTIRE UNDERSTANDING BETWEEN THE COMPANY AND ME, AND THAT THIS UNDERSTANDING MAY BE CHARGED ONLY BY A WRITING WHICH MAKES SPECIFIC REFERENCES TO THIS APPLICATION FOR EMPLOYMENT AND IS SIGNED BY THE COMPANY.

I HEREBY CONSENT AND AUTHORIZE THE EMPLOYER OR ITS AGENT TO OBTAIN A COPY OF MY MOTOR VEHICLE REPORT (here after “MVR”) FROM THE APPLICABLE DEPARTMENT OF MOTOR VEHICLES, AND TO USE SUCH “MVR” FOR THE PURPOSE (S) THESE ENTITIES DEEM APPROPRIATE.

I UNDERSTAND THAT THE “MVR” OBTAINED MAY OR MAY NOT BE USED FOR INSURANCE/UNDERWRITING PURPOSES TO VERIFY INFORMATION I HAVE PROVIDED TO A POTENTIAL EMPLOYER. I ALSO UNDERSTAND THAT SAID “MVR” MAY BE OBTAINED FROM A CONSUMER REPORTING AGENCY AND I SO AUTHORIZE SUCH METHOD.

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