EMPLOYMENT

Employment

Standard Application for Employment

Step 1 of 14

Standard Application for Employment

It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classifications.

Please carefully read and answer all questions. You will not be considered for employment if you fail to completely answer all the questions on this application. You may attach a résumé. but all questions must be answered.

"Employer"

Position applying for

Personal Data

Name

Address

Street Address City State / Province / Region ZIP / Postal Code

Home Telephone Number

Business Telephone Number

Cellular Telephone Number

Date you can start work

MM slash DD slash YYYY

Salary Desired

Please enter a number greater than or equal to 0.

Do you have a High School Diploma or GED?

Yes

POSITION INFORMATION - Check all that you are willing to work

Hours

Full Time

Part Time

Time of Day

Days

Evenings

Shift

Swing

Graveyard

Weekends

Status

Regular

Temporary

Third Choice

Are you authorized to work in the U.S. on an unrestricted basis?

Yes

Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant for employment.)

Yes

If yes, explain:

Have you been told the essential functions of the job or have you been viewed a copy of the job description listing the essential functions of the job?

Yes

Can you perform these essential functions of the job with or without reasonable accommodation?

Yes

QUALIFICATIONS

Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges, degrees, vocational or technical programs, and military training.

School

School Name

Degree

Address/City/State

SPECIAL SKILLS

List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.

Skills List

REFERENCES

Please list three professional references not related to you, with name, address, phone number, and relationship. If you don't have three professional references, then list personal, unrelated references.

References

Name

Address/City/State

Phone

Relationship

WORK HISTORY

Start with your present or most recent employment and work back. (INCLUDE PAID AND UNPAID POSITIONS)

How many work experiences will you list?

Job Title #1

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Company Name

Supervisor's Name

Phone Number

City

State

Zip

Please enter a number greater than or equal to 0.

Duties

Reason for Leaving

Starting Salary

Please enter a number greater than or equal to 0.

Ending Salary

Please enter a number greater than or equal to 0.

May we contact your present employer?

Yes

N/A

Job Title #2

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Company Name

Supervisor's Name

Phone Number

City

State

Zip

Please enter a number greater than or equal to 0.

Duties

Reason for Leaving

Starting Salary

Please enter a number greater than or equal to 0.

Ending Salary

Please enter a number greater than or equal to 0.

Job Title #3

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Company Name

Supervisor's Name

Phone Number

City

State

Zip

Please enter a number greater than or equal to 0.

Duties

Reason for Leaving

Starting Salary

Please enter a number greater than or equal to 0.

Ending Salary

Please enter a number greater than or equal to 0.

Job Title #4

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Company Name

Supervisor's Name

Phone Number

City

State

Zip

Please enter a number greater than or equal to 0.

Duties

Reason for Leaving

Starting Salary

Please enter a number greater than or equal to 0.

Ending Salary

Please enter a number greater than or equal to 0.

Job Title #5

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Company Name

Supervisor's Name

Phone Number

City

State

Zip

Please enter a number greater than or equal to 0.

Duties

Reason for Leaving

Starting Salary

Please enter a number greater than or equal to 0.

Ending Salary

Please enter a number greater than or equal to 0.

Job Title #6

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Company Name

Supervisor's Name

Phone Number

City

State

Zip

Please enter a number greater than or equal to 0.

Duties

Reason for Leaving

Starting Salary

Please enter a number greater than or equal to 0.

Ending Salary

Please enter a number greater than or equal to 0.

Job Title #7

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Company Name

Supervisor's Name

Phone Number

City

State

Zip

Please enter a number greater than or equal to 0.

Duties

Reason for Leaving

Starting Salary

Please enter a number greater than or equal to 0.

Ending Salary

Please enter a number greater than or equal to 0.

Job Title #8

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Company Name

Supervisor's Name

Phone Number

City

State

Zip

Please enter a number greater than or equal to 0.

Duties

Reason for Leaving

Starting Salary

Please enter a number greater than or equal to 0.

Ending Salary

Please enter a number greater than or equal to 0.

I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize the Employer to make an investigation of any of the facts set forth in this application and release the Employer from any liability. The employer may contact any listed references on this application.

I acknowledge and understand that the company is an "at will" employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party.

Applicant Signature

Date

MM slash DD slash YYYY

START HERE: Employers must ensure the form instructions are available to employees when completing this form. Employers are liable for failing to comply with the requirements for completing this form. See below and the Instructions.

ANTI-DISCRIMINATION NOTICE: All employees can choose which acceptable documentation to present for Form 1-9. Employers cannot ask employees for documentation to verify information in Section 1, or specify which acceptable documentation employees must present for Section 2 or Supplement B, Reverification and Rehire. Treating employees differently based on their citizenship, immigration status, or national origin may be illegal.

Section 1. Employee Information and Attestation:

Employees must complete and sign Section 1 of Form 1-9 no later than the first day of employment, but not before accepting a job offer.

Last Name (Family Name)

First Name (Given Name)

Middle Initial (if any)

Other Last Names Used (if any)

Address (Street Number and Name)

Apt. Number (if any)

City or Town

State

ZIP Code

Date of Birth

MM slash DD slash YYYY

U.S. Social Security Number

Employee's Email Address

Employee's Telephone Number

Consent

I am aware that federal law provides for imprisonment and/or fines for false statements, or the use of false documents, in connection with the completion of this form. I attest, under penalty of perjury, that this information, including my selection of the box attesting to my citizenship or immigration status, is true and correct.

Check one of the following boxes to attest to your citizenship or immigration status

1. A citizen of the United States

2. A noncitizen national of the United States

3. A lawful permanent resident

4. An alien authorized to work until

Enter USCIS or A-Number

exp. date, if any

If you check Item Number 4. , enter one of these:

USCIS A-Number

Form 1-94 Admission Number

Foreign Passport Number and Country of Issuance

Signature of Employee

Today's Date

MM slash DD slash YYYY

Section 2. Employer Review and Verification:

Employers or their authorized representative must complete and sign Section 2 within three business days after the employee's first day of employment, and must physically examine, or examine consistent with an alternative procedure authorized by the Secretary of DHS, documentation from List A OR a combination of documentation from List B and List C. Enter any additional documentation in the Additional Information box; see Instructions.

List A

Document Title 1

Issuing Authority

Document Number (if any)

Expiration Date (if any)

MM slash DD slash YYYY

Add another document?

Yes

Document Title 2

Issuing Authority

Document Number (if any)

Expiration Date (if any)

MM slash DD slash YYYY

Add another document?

Yes

Document Title 3

Issuing Authority

Document Number (if any)

Expiration Date (if any)

MM slash DD slash YYYY

List B and List C

List B

List C

Issuing Authority

Document Number (if any)

Expiration Date (if any)

MM slash DD slash YYYY

Expiration Date (if any)

MM slash DD slash YYYY

Additional Information

Checkbox

Check here if you used an alternative procedure authorized by DHS to examine documents.

Certification: I attest, under penalty of perjury, that (1) I have examined the documentation presented by the above-named employee, (2) the above-listed documentation appears to be genuine and to relate to the employee named, and (3) to the best of my knowledge, the employee is authorized to work in the United States.

First Day of Employment

MM slash DD slash YYYY

Last Name, First Name and Title of Employer or Authorized Representative

Signature of Employer or Authorized Representative

Today's Date

MM slash DD slash YYYY

Employer's Business or Organization Name

Employer's Business or Organization Address, City or Town, State, ZIP Code

Employee Alcohol and Drug Statement

Sec. 40.25(j) As the employer, you must also ask the employee whether he or she has tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which the employee applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years. If the employee admits that he or she had a positive test or a refusal to test, you must not use the employee to perform safety-sensitive functions for you, until and unless the employee documents successful completion of the return-to-duty process. (see Sec. 40.25(b) (5) and (e)).

Employee Name

Social Security No.

Have you tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years?

Check

Yes

Employee Signature:

Date

MM slash DD slash YYYY

Witnessed By(Signature):

Date

MM slash DD slash YYYY

AUTHORIZATION FOR RELEASE OF INFORMATION FOR EMPLOYMENT SCEENING

Driver Record Screening Disclosure

I hereby authorize Embark Safety LLC and its designated agents and representatives to conduct a comprehensive review of my driver record background through a consumer report and/or an investigative consumer report to the generated for employment, promotion, reassignment or retention as an employee. I understand that the scope of the consumer report/investigative consumer report may include information about my character, general reputation, personal characteristics, and mode of living as well as information that is not limited to, the following areas: name and dates of previous/current employment, word experience, Bureau of Workers Compensation/Claims, criminal history records (form local, state, federal, international and other law enforcement agencies' records), sexual offenders lists, want and warrants records, motor vehicle records, military records, educational verification, license verification, credit history, civil cases, OIG/GSA, USA PATRIOT Act/OFAC, any sanction list, FBI finger printing, internet searches, social media information, and drug testing. Upon Request, Embark Safety LLC will supply a copy of the completed consumer report along with a copy of an individual's rights under the Fair Credit Reporting Act.

Authorization and Release

Name

, authorize the complete release of these records or data pertaining to me which an individual, company, firm, corporation, or public agency may have. I authorize the full release of the information described above, without any reservation, throughout any duration of my employment at

Company Name

I hereby release Embark Safety LLC, and its agents, officials, representatives, or assigned agencies, including officers, employees, or related personnel both individually and collectively, from any and all liability for damages of whatever kind, which may at any time, result to me, my heirs, family or associates because of compliance with this authorization for release form. I certify that all information provided below is correct to the best of my knowledge. This authorization and consent shall be valid in original, fax, or copy form. The following information is required by law enforcement agencies and other entities for identification purposes when checking records. It is confidential and will not be used for any other purpose.

Applicant's First Name

Middle Name

Last Name

Maiden/AKA/Previous Name(s)

Drive License Number

State

Date of Birth(This will not affect the hiring decision)

MM slash DD slash YYYY

*California, Minnesota, Massachusetts, Maine and Oklahoma Applicants: please check this box to have a copy of your report emailed directly to your email:

Notice to California Applicants: Under section 1786.22 of California Civil Code, you have the right to request from Embark Safety LLC, upon proper identification, the nature and substance of all information in files pertaining to you, including the sources of information, and recipients of any reports on you, which Embark Safety LLC has previously furnished within the two-year period preceding your request. You may view the file maintained on you by Embark Safety LLC during normal business hours. You may also obtain a copy of this file, upon submitting proper identification. Upon making a written request, you may receive a summary of your report.Notice to Maine Applicants: Under Chapter 210 Section 1314 of Maine revised Statutes, you have the right, upon request, to be informed within 5 business days of such a request to whether or not an investigative consumer report was requested. If such report was obtained, you may contact the Consumer Reporting Agency and request a copy.Notice to Massachusetts Applicants: Under Mass. Ann. Laws chapter. 93 §§ 50, a Consumer Reporting Agency may furnish a report if intended to be utilized for employment purposes.Notice to New York Applicants: Under Article 25 Section 380-c (b) (2) of the New York General business Law, you have the right, upon written request, to be informed of whether or not an investigative consumer report was requested. Under Article 25 Section 380-g of the New York General Business Law, should a consumer report received by an employer contain criminal conviction information, the employer must provide to the applicant or employee who is the subject of the report, a printed or electronic copy of Article 23-A of the New York Correction Law, which governs the employment of persons previously convicted of one or more criminal offenses.

Please initial here to acknowledge receipt of Article 23-A of New York Correction Law

Signature

Date

MM slash DD slash YYYY

All newly hired employees must acknowledge and agree to the following at the start of their employment: Eagle Energy Oilfield Resources has provided all required tools, personal protective equipment (PPE), and necessary training to ensure a safe and effective work environment.

Employee Name

Date

MM slash DD slash YYYY

Position

Pay rate

Please enter a number greater than or equal to 0.

Training Needed

Personal Protection Equipment provided checklist:

Leather Work Gloves ($10)

Leather Impact Gloves ($25)

Safety Glasses ($5)

Hard Hat ($25)

H2S Monitor ($120)

Quad Gas Monitor ($500)

Drug Test ($100)

Other

Other:

At Eagle Energy Oilfield Resources, we prioritize safety and are committed to ensuring all employees have the proper safety equipment. If an item breaks or becomes worn, we will replace it on a I-for-I basis. Simply return the old item, and we'll provide you with a new one. However, if you lose or dispose of an item, it becomes the employee's responsibility to replace it. Employees can purchase replacements directly from the company, with the corresponding cost deducted from their paycheck, as listed next to the product above. Your safety is our priority, and we want to ensure you're always equipped. All new employees must agree to the terms of employment. If you do not agree, this may not be the right workplace for you. There is a 90-day probation period, which includes required training and drug testing. If you choose to quit within these 90 days, you will be responsible for reimbursing the company for all training, drug tests, and PPE, which will be deducted from your paycheck. All pricing is seen above in the check list. Any employee with a vehicle is required to keep it clean. If vehicle is returned in bad condition you will be charged cleaning fee. If your truck has any tools you as the pusher are responsible for anything missing at anytime, will be deducted off your check.

Employee Signature

Supervisor Signature

Vacation Eligibility, Schedule, and Pay

The Company grants annual vacation with pay to regular full-time employees who meet the service requirement as follows:

After one (1) year of full-time employment, each employee is entitled to five (5) days = forty (40) hours paid vacation annually.
Vacation requests must be made at least two (2) weeks in advance.
No unused vacation time may be carried over into the next vacation year.
No unused vacation time may be bought back by the company.
Job requirements will always have precedent over vacation schedules.
Pay for vacation time will be at the employee's regular rate of pay. Paid vacation time will not be considered as time worked for the purpose of computing overtime for hourly employees.

Holidays

The company recognizes the following paid holidays; however, the company may decide to work on a holiday depending upon job requirements. Eligible employees will be paid eight (8) hours at regular rate of pay for the list of approved holidays if no jobs are available, but are always considered "on-call" and must be eligible to report to work. If an employee is called out on a holiday, the employee will instead be paid the overtime rate for hours worked. Employees must work/be available to work the day before the holiday and the day after the holiday in order to receive holiday pay.

Employees must be employed full time for 180 days to receive any company paid holiday hours.

The company will observe the following five (5) paid holidays each year:

Holiday	Date
Memorial Day	Last Monday in May
July 4th	July 4th
Labor Day	First Monday in September
Thanksgiving Day	Fourth Thursday of November
Christmas Day	December 25

Employee Name

Employee Signature

Pay Schedule

Eagle Energy Oilfield Resources LLC is on a weekly payroll schedule Monday-Sunday, and checks/direct deposits are delivered every Thursday. Due to the verification of hours process, payment is made on the 2nd Thursday after the end of the payroll period. Paychecks can be picked up at 12pm in the training room of the mechanic shop.

Example of Payroll Schedule:

MONTH

M	T	W	T	F	S	S
	1	2	3	4	5	6
7	8	9	10	11	12	13
14	15	16	17	18	19	20
21	22	23	24***	25	26	27
28	29	30	31

*** Example Pay Date.

Employee Name

Employee Signature

APPLICANTS CERTIFICATION AND AGREEMENT

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize ( Eagle Energy Oilfield Resources, LLC )to verify their accuracy and to obtain reference information on my work performance. I hereby release ( Eagle Energy Oilfield Resources, LLC ) from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

I understand that, if employed, falsified statements of any kind omissions of facts called for on this application shall be considered sufficient basis for dismissal.

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause.

Signature of Applicant

Date

MM slash DD slash YYYY

RECEIPT AND ACKNOWLEGMENT STATEMENT

I have RECEIVED and READ the safety Policy and Procedure manual, drug and alcohol and substance abuse policies of Eagle Energy Oilfield Resources, LLC. I UNDERSTAND that by following these rules, I will help to create a safe place to work for myself and my co-workers. I ACCEPT this responsibility to make SAFETY my highest priority. I also UNDERSTAND that this will be filled as a part of my permanent personnel record.

Do NOT SIGN unless you fully understand all items covered by this manual.
DISCUSS any part of the manual that you DO NOT UNDERSTAND with your supervisor or safety representative BEFORE signing.
Eagle Energy Oilfield Resources, LLC personnel SHALL ABIDE by the safety rules and regulations of any company they are working for as well as those Eagle Energy Oilfield Resources, LLC.
7:00 AM, be at the shop, ready to work, this is MANDATORY. Unexcused or tardiness WILL NOT BE TOLERATED. If you do not abide by these rules, it is grounds for termination.
If you were picked for a DRUG/ALCOHOL TEST, testing is on the same day as notified. If you do not comply with this, it is the same as refusing to take the test.
Refusing the test will not be acceptable!

EMPLOYEE SIGNATURE

Date

MM slash DD slash YYYY

SAFETY COORDINATOR

ACKNOWLEDGMENT OF DRUG AND ALCOHOL CONTRABAND POLICY RECEIPT

I hereby acknowledge that I have been provided a copy of the Eagle Energy Oilfield Resources, LLC drug/alcohol policy requirements. I understand that disciplinary action up to and including termination, will result if) violate this policy.

I also hereby authorize and consent to disclosure by Eagle Energy Oilfield Resources, LLC and its agents, including, but not limited to, any collecting and testing agencies, of the drug and alcohol test results and any related information to customers of Eagle Energy Oilfield Resources, LLC and its authorized agents, assigns, or representatives.

Employees Signature

Date

MM slash DD slash YYYY

Employee Name

***This consent form is for release of NON-DOT tests. Please follow (101regulations if you choose to submit DOT test results in place of NON-DOT in order to meet requirements of a specific client***

Form W-4

Department of the Treasury
Internal Revenue Service

Employee's Withholding Certificate

Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay.

Give Form W-4 to your employer.

Your withholding is subject to review by the IRS.

OMB No. 1545-0074

2026

Step 1: Enter Personal Information

(a) First name and middle initial

Last name

(b) Social security number

Does your name match the name on your social security card? If not, to ensure you get credit for your earnings, contact SSA at 800-772-1213 or go to www.ssa.gov.

Address

Street Address City State / Province / Region ZIP / Postal Code

(c)

Single or Married filing separately

Married filling Jointly or Qualifying surviving spouse

Head of household (Check only If you're unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)

Caution: To claim certain credits or deductions on your tax return, you (and/or your spouse if married filing jointly) are required to have a social security number valid for employment. See page 2 for more information.

TIP: Consider using the estimator at www.irs.gov/W4App to determine the most accurate withholding for the rest of the year if you: are completing this form after the beginning of the year; expect to work only part of the year; or have changes during the year in your marital status, number of jobs for you (and/or your spouse if married filing jointly), dependents, other income (not from jobs), deductions, or credits. Have your most recent pay stub(s) from this year available when using the estimator. At the beginning of next year, use the estimator again to recheck your withholding.

Complete Steps 2—4 ONLY if they apply to you; otherwise, skip to Step 5. See page 2 for more information on each step, who can claim exemption from withholding, and when to use the estimator at www.irs.gov/W4App.

Step 2: Multiple Jobs or Spouse Works

Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse also works. The correct amount of withholding depends on income earned from all of these jobs.

Do only one of the following.

(a) Use the estimator at www.irs.gov/W4App for the most accurate withholding for this step (and Steps 3–4). If you or your spouse have self-employment income, use this option; or

(b) Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below; or

(c) If there are only two jobs total, you may check this box. Do the same on Form W-4 for the other job. This option is generally more accurate than Step 2(b) if pay at the lower paying job is more than half of the pay at the higher paying job. Otherwise, Step 2(b) is more accurate

Complete Steps 3-4(b) on Form W-4 for only ONE of these Jobs. Leave those steps blank for the other jobs. (Your withholding will be most accurate If you complete Steps 3—4(b) on the Form W-4 for the highest paying job.)

Step 3: Claim Dependent and Other Credits

If your total income will be $200,000 or less ($400,000 or less if married filing jointly):

(a) Multiply the number of qualifying children under age 17 by $2,200

3(a)

Please enter a number greater than or equal to 0.

(b) Multiply the number of other dependents by $500

3(b)

Please enter a number greater than or equal to 0.

Add the amounts from Steps 3(a) and 3(b), plus the amount for other credits.

Enter the total here

Please enter a number greater than or equal to 0.

Step 4: Other Adjustments

(a) Other income (not from jobs). If you want tax withheld for other income you expect this year that won't have withholding, enter the amount of other income here. This may include interest, dividends, and retirement income.

4(a)

Please enter a number greater than or equal to 0.

(b) Deductions. use the Deductions Worksheet on page 4 to determine the amount of deductions you may claim, which will reduce your withholding. (If you skip this line, your withholding will be based on the standard deduction.) Enter the result here

4(b)

Please enter a number greater than or equal to 0.

(c) Extra withholding. Enter any additional tax you want withheld each pay period

4(c)

Please enter a number greater than or equal to 0.

Exempt from withholding

I claim exemption from withholding for 2026, and I certify that I meet both of the conditions for exemption for 2026. See Exemption from withholding on page 2. I understand I will need to submit a new Form W-4 for 2027

Step 5: Sign Here

Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.

Employee's signature (This form is not valid unless you sign it.)

Date

MM slash DD slash YYYY

Employers Only

Employer's name and address

First date of employment

MM slash DD slash YYYY

Employer identification number (EIN)

Intuit QuickBooks Payroll

Employee Direct Deposit Authorization

Instructions

Employee: Fill out and return to your employer. Employer:

This document must be signed by employees requesting automatic deposit of paychecks and retained on file by the employer. Do not send this form to Intuit. Employees must attach a voided check for each of their accounts {o help verify their account numbers and bank routing numbers.

Bank Name

Account 1 Type

Checking

Savings

Bank routing number (ABA number)

Account Number

Percentage or dollar amount to be deposited to this account

Section Break

Account 2 (remainder to be deposited to this account)

Account 2 Type

Checking

Savings

Bank routing number (ABA number)

Account Number

Attach a voided check for each account here

Max. file size: 64 MB.

Authorization (enter your company name in the blank space below)

This Authorities

(the "Company")

to send credit entries (and appropriate debit and adjustment entries), electronically or by any other commercially accepted method, to my (our) account(s) indicated below and to other accounts I (we) identify in the future (the "Account"). This authorizes the financial institution holding the Account to post all such entries. I agree that the ACH transactions authorized herein shall comply with all applicable U.S. Law. This authorization will be in effect until the Company receives a written termination notice from myself and has a reasonable opportunity to act on it.

Authorized Signature

Employee ID #

Name

Date

MM slash DD slash YYYY

EMPLOYMENT

Employment

Standard Application for Employment

Standard Application for Employment

Personal Data

POSITION INFORMATION - Check all that you are willing to work

QUALIFICATIONS

SPECIAL SKILLS

REFERENCES

WORK HISTORY

Section 1. Employee Information and Attestation:

Section 2. Employer Review and Verification:

List A

List B and List C

Employee Alcohol and Drug Statement

AUTHORIZATION FOR RELEASE OF INFORMATION FOR EMPLOYMENT SCEENING

Driver Record Screening Disclosure

Authorization and Release

Vacation Eligibility, Schedule, and Pay

Holidays

Pay Schedule

Example of Payroll Schedule:

APPLICANTS CERTIFICATION AND AGREEMENT

RECEIPT AND ACKNOWLEGMENT STATEMENT

ACKNOWLEDGMENT OF DRUG AND ALCOHOL CONTRABAND POLICY RECEIPT

Employee's Withholding Certificate

Step 1: Enter Personal Information

Step 2: Multiple Jobs or Spouse Works

Step 3: Claim Dependent and Other Credits

Step 4: Other Adjustments

Step 5: Sign Here

Employers Only

Intuit QuickBooks Payroll

Section Break

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