Fair Credit Reporting Act In connection with my application for employment (including a contract for services) and, if hired, at any time during my employment, 1 understand that Avis Rent A Car System, LLC, or ally of its subsidiaries (hereinafter, the "Company") may obtain a Consumer Report about me for employment purposes. I understand that a Consumer Report is any report (including education, criminal background, employment history and credit) which bears upon my credit worthiness, capacity and standing, my general reputation, character, personal characteristics and lifestyle. I under stand such reports may be compiled from information provided by various federal, state and other consumer agencies which maintain records concerning my past activities relating to my driving, credit, civil or criminal, and other experiences including, but not limited to insurance claims. Such information also may be developed through personal interviews of neighbors, friends and associates.By my signature below, I authorize the procurement of a Consumer Report by the Company as part of the pre-employmeni background investigation, If hired, this authorization shall remain on file and shall serve as an ongoing authorization for the Company to procure Consumer Reports at any time during my employment.I understand that iii send a separate letter to Human Resources, the Company will advise me if a Consumer Report was requested, and provide me with the name, address and phone number of the consumer agency from which the report was requested, as well as, the nature and scope of the request, if applicable.I authorize, without reservation, any party or agency contacted by this employer to furnish the above-mentioned information.California, Minnesota & Oklahoma Applicants Only: Please check here to have a copy of your consumer report sent directly to you by the Consumer Reporting Agency at the address listed below.Email* Location Applying to:Anchorage AirportAnchorage DowntownAnchorage Main OfficeFairbanksJuneau AirportJuneau DowntownKenaiKodiakSitkaPrint Full NameList any other names or aliases you have used, and the dates you used them.Date of Birth MM slash DD slash YYYY Current Address Street Address City State / Province / Region ZIP / Postal Code Prior residences during the previous 7 yearsDriver’s License NumberStateConsumer Report AuthorizationApplicant NameDate MM slash DD slash YYYY Please read the following notice and provide responsive information to the question below:In response to the questions below, you are not required to disclose the existence of any arrest which resulted in a non-conviction, or any conviction which has been erased, sealed, expunged, or otherwise eradicated by statute or court order. Criminal records subject to erasure are those pertaining to a finding of delinquency or that a child was a member of a family with service needs; an adjudication as a youthful offender; a criminal charge for which you were found not guilty; or a conviction for which you received an absolute pardon. If your criminal records have been erased in accordance with state or federal law, you are deemed to have never been arrested with respect to those proceedings. If in Ca1iforni~ you need not identify any conviction for a marijuana offense if the conviction is more than two years old. If in Massachusetts, you may omit a first conviction for drunkenness, simple assault, speedin& minor traffic violations, affray or disturbance of the peace. All other states please disclose all convictions or current arrests.Have you ever been convicted of a crime? Yes NoAre you currently under arrest or indictment for any crime which has not yet been dismissed or adjudicated? Yes NoFor any "yes" answer, please provide an explanation below indicating the date of the conviction or currently pending arrest or indictment, the nature of the offense, the name and location of the court, the penalty imposed or requested, if any, and the disposition or current status of the case.NOTE: Such conviction or charge does not automatically bar employment. The job relatedness of the crime and factors such as nature of the offense, your age at the time of offense, the amount of time that has transpired, and your opportunity for rehabilitation will he considered in the hiring decision.Explanation of Yes AnswerI certify that the foregoing information supplied by me is true and correct. I understand that the provision of false information, whenever discovered, is grounds for withdrawal of an employment offer or inunediate dismissal.Applicant’s SignatureNameThis field is for validation purposes and should be left unchanged.