In connection with my suitability for employment with Kocina Marketing Companies, or if employed, I understand that prior to or at any time after my employment commences a consumer report may be requested for employment purposes from InfoLink Screening Services, Inc. (herein, InfoLink) from public records including, but not limited to, social security trace, motor vehicle history report, workers' compensation information and criminal history to the extent permitted by law from various local, state and federal agencies. Further, I understand that an Experian Employment Insight Report, TransUnion Pre-Employment Evaluation Report or Equifax Credit Report for Employment may be requested. Finally, I understand that an investigative consumer report may be requested, as required under $606(a)(1) of the Fair Credit Reporting Act (FCRA), 15 U.S.C. $1681 et seq., and I understand that this report will include information as to my character, general reputation, personal characteristics, mode of living, work habits, performance, experience, as well as reasons for termination of past employment, whichever are applicable, obtained through personal interviews with associates who have knowledge concerning such items of information.

I VOLUNTARILY AND KNOWINGLY AUTHORIZE ANY PRESENT OR PAST EMPLOYER OR SUPERVISOR, COLLEGE OR UNIVERSITY OR OTHER INSTITUTION OF LEARNING, ADMINISTRATOR, LAW ENFORCEMENT AGENCY, STATE AGENCY, LOCAL AGENCY, FEDERAL AGENCY, CREDIT BUREAU, COLLECTION AGENCY, PRIVATE BUSINESS, MILITARY BRANCH OR THE NATIONAL PERSONNEL RECORDS CENTER, PERSONAL REFERENCE, AND/OR ANY OTHER PERSONS TO GIVE RECORDS OR INFORMATION THEY MAY HAVE CONCERNING MY CRIMINAL HISTORY, MOTOR VEHICLE HISTORY, SOCIAL SECURITY NUMBER, EARNINGS HISTORY, CHARACTER, EMPLOYMENT (INCLUDING REASONS FOR TERMINATION), CREDIT HISTORY, CREDIT CAPACITY, CREDIT STANDING OR ANY OTHER INFORMATION REQUESTED BY INFOLINK DEEMED PERTINENT TO MY EMPLOYMENT.

In connection with my suitability for employment with Kocina Marketing Companies, or if employed, I understand that prior to or at any time after my employment commences a consumer report may be requested for employment purposes from InfoLink Screening Services, Inc. (herein, InfoLink) from public records including, but not limited to, social security trace, motor vehicle history report, workers' compensation information and criminal history to the extent permitted by law from various local, state and federal agencies. Further, I understand that an Experian Employment Insight Report, TransUnion Pre-Employment Evaluation Report or Equifax Credit Report for Employment may be requested. Finally, I understand that an investigative consumer report may be requested, as required under $606(a)(1) of the Fair Credit Reporting Act (FCRA), 15 U.S.C. $1681 et seq., and I understand that this report will include information as to my character, general reputation, personal characteristics, mode of living, work habits, performance, experience, as well as reasons for termination of past employment, whichever are applicable, obtained through personal interviews with associates who have knowledge concerning such items of information.

In accordance with the Fair Credit Reporting Act, the California Consumers Investigative and Credit Reporting Agencies Acts and the Federal Trade Commission staff opinions, I understand that I have the right to request a complete and accurate disclosure of the nature and scope of the investigation requested. Further, 1 am entitled to know if employment is denied because of information obtained by my prospective employer from a reporting agency. If so, I will be so advised in writing and be given the name, address and toll free telephone number of the agency, a statement that the action was based in whole or in part on information contained in the report, and written notice that I have the right, if I request, () to obtain within sixty days a free copy of the report from the reporting agency (under no circumstances shall such cost exceed the actual costs of duplication), and from any other consumer reporting agency which compiles and maintains files on consumers on a nationwide basis; and, (ii) to dispute the accuracy or completeness of any information in a consumer report furnished by the reporting agency.! understand that upon my request, with reasonable notice and after furnishing proper identification, InfoLink's trained personnel will provide me with investigative information in my file during normal business hours in person, upon written request by certified mail to a specified addressee or by telephone, as permitted by law. Further, I understand that should I wish to review my file in person, I am permitted to be accompanied by one other person of my choosing who shall furnish reasonable identification.

I understand that InfoLink is a consumer reporting agency and it is InfoLink's policy to not be involved in or make hiring decisions or recommendations; however, I do understand that InfoLink will provide a written explanation of any coded information contained in my file. InfoLink's privacy policy limits the information it provides to the subscriber named herein; however, I hereby authorize the subscriber to share such information with parties in interest who need to know such information to protect them and their employees. Such information may include names and dates of other subscriber inquiries to InfoLink. InfoLink does not sell or otherwise provide any of the information found in its background investigations to any other party.

I understand that any consumer report or investigative consumer report requested will be used strictly for employment purposes as defined under $603(n) and authorized under $604(a)(3)(B) of the Fair Credit Reporting Act, as a report to be used for the purpose of evaluation for employment, promotion, reassignment or retention as an employee. I further understand that request for workers' compensation information shall be provided after a conditional job offer is made and may include any and all injuries pursuant to state law and in compliance with the Federal Americans with Disabilities Act. In addition, I understand that any offer of employment, promotion, reassignment or retention will be conditional upon the receipt of satisfactory information as required by the subscriber, and that to be considered for employment, promotion, reassignment or retention, I must authorize the procurement of such report(s). A photographic or faxed copy of this form shall be as valid as the original.