Driver License Examiner Employment Application Form

Disclaimer

Please read the following statement:

The Manatee County Tax Collector's Office offers reasonable accommodation in the employment process for individuals with disabilities. If you need assistance in the application or hiring process to accommodate a disability, you may request an accommodation at any time by contacting JobApplicant@taxcollector.com.

The Manatee County Tax Collector’s Office is an Equal Opportunity Employer. If you do not have access to a computer, most public libraries have computers available for public use.

By clicking 'Next' below you certify that you have read and acknowledge the above information.

CONSENT TO RECEIVE, REVIEW, ACCESS, SIGN, & AUTHENTICATE CERTAIN DOCUMENTS, FORMS, LETTERS, & OTHER INFORMATION ELECTRONICALLY(“E-SIGNATURE DISCLOSURES & CONSENT”)

PLEASE READ THE FOLLOWING CAREFULLY
By checking each box and clicking the “Next” button (all below), you are agreeing to electronically access, receive, review, sign, and authenticate certain documents, forms, and/or letters (“Materials”) covered by the federal Electronic Signatures in Global and National Commerce Act (“E-SIGN”), various state electronic transactions acts (“ETAs”), and/or the separate state laws of Illinois, New York, and Washington, including but not limited to the following Materials:

(a) Application for employment;
(b) Background check communication or disclosure; and/or
(c) Any other employment-related documents (e.g., wage statements, commission plans, etc.).

These E-Signature Disclosures & Consent apply to all Materials, both current and future, related to your application for, or possible employment with, the Manatee County Tax Collector's Office (“Office”).

By checking the box and clicking the “Next” button (all below), you are agreeing that your electronic signature is the equivalent of your handwritten (or wet) signature, with all the same legal and binding effect. In certain cases throughout your employment, you may be asked to click buttons labeled “I Agree,” “I Acknowledge,” or using similar words, or otherwise electronically to acknowledge, accept, review, etc. Materials. These E-Signature Disclosures & Consent apply to those instances as well. You also understand that, in its sole discretion, the Office may mail, hand-deliver, communicate, or otherwise send you hard-copy Materials.

You may obtain a paper copy of any electronic Materials by sending a written request to Manatee County Tax Collector’s Office, 819 301 Blvd W, Bradenton, FL 34205, attn. RMLO or rmlo@taxcollector.com.

You may withdraw your consent to receive, review, access, sign, and authenticate any additional electronic Materials at any time by canceling these E-Signature Disclosures & Consent. You may cancel these E-Signature Disclosures & Consent and withdraw your consent now by not completing this E-Signature Disclosures & Consent form and exiting the system. You may cancel these E-Signature Disclosures & Consent and withdraw your consent in the future by sending a written cancellation request to jobapplicant@taxcollector.com. Any withdrawal of your consent will be effective after a reasonable period of time in order for the Office to process your withdrawal. Withdrawal of your consent will have no legal effect on the validity, effectiveness, or enforceability of (a) any authorization, consent, or e-signature provided by you prior to the effective date of your withdrawal or (b) any document, form, letter, etc. that was provided or made available to you in electronic format prior to the effective date of your withdrawal. Withdrawal of your consent (i.e., canceling these E-Signature Disclosures & Consent) also will not relieve you from the obligation to complete all required Materials. Withdrawal/canceling will require you to receive, review, access, sign, and authenticate these Materials in hard copy instead of electronically. Receiving, reviewing, accessing, signing, and authenticating certain Materials in either electronic or hard copy is a condition of initial and/or continued employment.

You must update the Office regarding the information necessary to contact you electronically (including your personal email address) by sending a written cancellation request to jobapplicant@taxcollector.com. If you are employed, the Office may electronically send Materials to your Office email address or your personal email address, in its discretion.

To access these electronic Materials from a home computer or personal mobile device, you must have (a) a personal computer or mobile device and an operating system capable of receiving, accessing, displaying, and either printing or storing information, (b) an Internet connection, and (c) Internet Browser Software such as Internet Explorer®, Google Chrome®, Safari®, or Firefox®. Your Internet Browser Software must support 128-bit encryption and Secure Sockets Layer (SSL) protocol. If you are able to see these E-Signature Disclosures & Consent, your hardware and software should allow you to access these electronic Materials.

To retain any of these electronic Materials on your home computer or personal device, you may either print or download them from your computer or device. To print these Materials on your computer, you will need a printer connected to your computer with adequate paper. To download these Materials on your computer, you will need an available storage medium, like a hard drive on your computer or a removable thumb drive. To print these Materials on your mobile device, you will need a printer linked with your device (e.g., via Wi-Fi, Bluetooth®, etc.) and/or an application (app) that allows for printing. To store these Materials on your mobile device you will need (1) sufficient storage space on your mobile device and (2) an app or function that allows for the capture of electronic data (e.g., a screenshot). Please follow the instructions for your particular computer operating system and/or software to print and/or to download these Materials. Each individual screen may need to be printed and/or downloaded separately. If you have trouble printing and/or downloading, please contact the manufacturer of your personal computer or mobile device, computer operating system, web browser, app, or other relevant software or another information source of your choosing.
By checking each box and clicking the "Next" button (all below), I understand that I am: *

1. Confirming that I can access these E-Signature Disclosures & Consent. 2. Confirming that I have an email address and that the computer I intend to use to access documents electronically has the hardware and software requirements described in these E-Signature Disclosures & Consent, to access and to retain these electronic Materials. 3. Agreeing to electronically access, receive, review, sign, and authenticate Materials related in any way to my employment with the Manatee County Tax Collector's Office, in place of hard copy/paper documents and handwritten signatures. 4. Confirming that I understand how to cancel these E-Signature Disclosures & Consent, should I ever want to do so. 5. Consenting to update the Manatee County Tax Collector's Office regarding the information necessary to contact me electronically (including my personal email address) by sending a written cancellation request to jobapplicant@taxcollector.com. 6. Agreeing that I have read, understand, and agree to all statements, agreements,and acknowledgements in these E-Signature Disclosures & Consent.

Employment Application

Please complete all of the information requested on the form below. All questions must be answered or this application will not be considered. If a question does not apply, answer “N/A”. Applications are active for 60 days. If you have not been employed within 60 days of the application submission date, a new application form must be completed to continue to be considered for employment.
Name:

First Name Middle Name Last Name
Phone Number: *
E-mail Address: *
example@example.com
Current Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
1. What position are you applying for? (Check all that apply) *

Part-time Driver License Examiner (Driving Skills Road Testing Only)
2. What date would you be available to work? *

Month Day Year
3. How did you learn of this opportunity? *

Insert in Mailing Social Media Indeed.com Taxcollector.com Outside Sign Lobby Sign Employee (provide full name) Other (please specify)
Employee or Other:
4. Have you applied for a position with the Manatee County Tax Collector before? *

Yes No
If yes, when?

Month Day Year
5. Have you worked under another name? *

Yes No
If yes, please provide name(s):
6. List all states where you have worked: *
7. Do you have the legal right to work in the United States? *

Yes No
8. Are you claiming Veterans' Preference? (see our veterans' preference FAQ for eligibility requirements and details; copy/paste link below into browser) *
http://taxcollector.com/contactapp/question_detail.cfm?question=1572&category=10&related=yes
If yes, you must attach a copy of your DD-214 or equivalent that indicates an Honorable Discharge along with any supporting documentation AND you must select the Veteran's Preference category that you are claiming below. Failure to provide sufficient documentation and/or mark the appropriate category below will disqualify you from claiming Veterans' Preference.

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You must select a Veteran's Preference category below:

A Veteran who has served on active duty and was released with a Honorable Discharge. A Veteran of any war who has served on active duty during a wartime period. Other
9. Have you ever been convicted of, pled guilty or no contest to a crime (or similar offense by court martial), had adjudication withheld for a criminal offense, entered a pre-trial intervention program, been placed on court-approved probation, or had a record expunged? *

Yes No
10. Have you ever been a defendant in a civil action suit for intentional tort such as battery or assault? *

Yes No
11. Are any criminal charges currently pending against you? *

Yes No
If you answered "yes" to questions 9, 10, or 11, provide a copy of the police report and/or other relevant documents.

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12. Have you ever been discharged or resigned from a position for fraud; dishonesty; money discrepancies; workplace violence; unauthorized disclosure of confidential, privileged or protected information, or a similar offense? *

Yes No
13. With your previous employer, have you been counseled (written warning(s), probation, suspension, demotions, etc.) in the past 12 months? *

Yes No
If you answered "yes" to questions 9-13 above, please explain in complete detail in the text box below. (Note: A "yes" response to questions 9 - 13 does not automatically disqualify you from employment.)

Education History
Education History
Did you graduate from High School? *

Yes No GED Still Attending
High School Name or Name of GED Issuing Authority: *
City and State of High School or GED Issuing Authority: *

Street Address

Street Address Line 2

City State / Province
Have you received a college degree from an US Educational Institution? *

Yes No
If you received a college degree from a US Educational Institution, make the appropriate selection below for the highest type of degree received and provide the college details. You must also attach a copy of the degree received to be used at a later date for verification purposes. Important: Falsely claiming to have earned a degree may be a violation of s. 817.566, Florida Statutes, or other state/federal laws.
Highest Type of Degree Received (Not in Progress) *
College/University Information *

College/University Name*

Street Address Line 2

City* State / Province*
Please upload a copy of your college degree below:

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References & Resume
References

Please provide the name, email and phone number for two (2) personal references that are not related to you.
Reference 1
Name: *

First Name Last Name
Email *
example@example.com
Phone Number *
Years Known: *
Reference 2
Name: *

First Name Last Name
Email *
example@example.com
Phone Number *
Years Known: *
You may upload your resume here (not required):

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Terms of Hire

Due to the nature of our business, complete honesty is an absolute requirement for working with the Manatee County Tax Collector. Since work at our office may involve dealing with large sums of money and with confidential information concerning our customers' personal matters, it is necessary that we have employees who have integrity and will maintain the confidentiality that is required in such an environment. Any individual who does not abide by the intent of this statement will be subject to dismissal.

CERTIFICATION

PLEASE READ THE FOLLOWING CAREFULLY
I understand that the following conditions may be required as a condition of the job: overtime, job rotation, shift assignment, weekend and holiday work. I agree to abide by the rules, regulations, and policies of the organization as well as those required by them. I understand and agree that I am free to terminate my employment at anytime with or without cause and with or without prior notice. I further understand and agree that the organization has the same right to terminate my employment and compensation at any time with or without cause and with or without notice.

I Certify

CERTIFICATION

PLEASE READ THE FOLLOWING CAREFULLY
I understand and agree that, in the future, I may be tested for drug use and that if I test positive I may be terminated from employment.

I Certify

CERTIFICATION

PLEASE READ THE FOLLOWING CAREFULLY
I understand that no person has the authority to enter into any agreement with me as to employment for any specified period of time or concerning the job or related conditions which are contrary to the rules and practices of the employer.

I Certify

CERTIFICATION

PLEASE READ THE FOLLOWING CAREFULLY
I understand that a person who knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his official duty shall be guilty of a misdemeanor of the second degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084, Florida Statutes.

I Certify

CERTIFICATION

PLEASE READ THE FOLLOWING CAREFULLY
I certify that all information contained in this application is true and correct to the best of my knowledge, and I understand that false or incorrect information in this application is grounds for disqualification from further consideration or for dismissal from employment. Further, I hereby authorize my former employer(s), school(s), reference(s) and any other individual or organization to provide information solicited by the Office of the Tax Collector, and I hereby release and discharge each of the above, including the Office of the Tax Collector, from any liability with respect to, or arising from, the release or dissemination of any such information for such purposes. I also authorize the Office of the Tax Collector to obtain my personal criminal background history.

Please check here and click the "Submit Application" button below to certify that you have read and understand the above statement and all certifications within this application.
Should be Empty:

CONSENT TO RECEIVE, REVIEW, ACCESS, SIGN, & AUTHENTICATE CERTAIN DOCUMENTS, FORMS, LETTERS, & OTHER INFORMATION ELECTRONICALLY(“E-SIGNATURE DISCLOSURES & CONSENT”)

Employment Application

CERTIFICATION

CERTIFICATION

CERTIFICATION

CERTIFICATION

CERTIFICATION