I,certify that the aforementioned information is true to the best of my knowledge. If am hired, I understand that false or misleading information in my application or interview may result in termination.

Criminal Release Authorization

and Staff Wages Agreement

Notification and Authorization to Release Information for Employment Purposes

The position for which I am being considered requires me to consent to a criminal background check as a condition of employment. I hereby authorize FLEX Staffing Company LLC, Inc. to conduct the criminal background check. In connection with this, I also authorize the use of law enforcement agencies and/or private background check organizations to assist FLEX Staffing Company LLC. in collecting this information. First Verify has been secured as a third party vendor (consumer reporting agency) to assist FLEX Staffing Company LLC collecting and verifying information. I am also aware that records of arrests on pending charges and/or convictions are not an absolute bar to employment. Such information will be used to determine whether the results of the background check reasonably bear on my trustworthiness or my ability to perform the duties of my position in a manner, which is safe for FLEX Staffing Company LLC. employees, customers, and vendors. By signing below, I am authorizing my background information to be released to FLEX Staffing Company LLC

STAFF WAGES AGREEMENT

I, hereby agree that I will be paid at a rate of _/hour. The following procedures must be met in order to receive the aforementioned wages. Failure to following the procedures will result in wages paid at $7.25/hour. The first 3 days of training will be paidat $7.25/hour, after which your regular rate applies. Employees Must:

1. Give a week's notice before quitting job.

2. Not walk out mid shift.

3. Not leave during training days.

4. Not leave in the first week.

5. Schedule time off/vacation a week in advance with FLEX.

6. Not be fired in the first week of work.

By signing below understand and agree to the staff wages agreement.

The information being requested is in accordance with Federal Regulations. It is voluntary and will not be used when considering you for employment with our company.

 

Announces we are now offering Medical Insurance with United Healthcare for Employees in compliance with the Affordable Care Act

The Affordable Care Act will take effect February 1, 2015

Variable employees are eligible after one year of full-time employment

Benefits- unlimited, brief outline of coverage below

·        Office Visits- $30 co-pay in network doctors

          $60 co-pay to see specialist

·        Deductible- $3,000 per person/$6,000 per family

·        Drugs- $10 co-pay for generic/$35 co-pay for approved name brand drugs

·        Name brand drugs and $50 co-pay for non-approved name brand drugs

·        Out of pocked limit $6,000 per person annually and $12,000 per family annually

·        Weekly cost $58

 

 

Please indicate below by placing an “X” if you will accept or reject the coverage

Department of the Treasury Internal Revenue Service

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.

. Does your name match the name on your social security card? to ensure you get credit for your earnings, coritact SSA at 800-772-1213 or go to www.ssa.gov.

Single or Married filing separately Married filing jointly or Qualifying widow(er) 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)

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, when to use the estimator at www.irs.gov/W4App, and privacy.

Step 2: 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. Multiple Jobs Do only one of the following. or Spouse Works (a) Use the estimator at www.irs.gov/W4App for most accurate withholding for this step (and Steps 3-4): or (b) Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below for roughly accurate withholding: 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 accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld TIP: To be accurate, submit a 2022 Form W-4 for all other jobs. If you (or your spouse) have self-employment income, including as an independent contractor, use the estimator. 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

If your total income will be $200,000 or less ($400,000 or less if married filing jointly): Multiply the number of qualifying children under age 17 by $2,000 Multiply the number of other dependents by $500

Add the amounts above and enter the total here

Step 4 (optional): 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. 4(a) This may include interest, dividends, and retirement income (b) Deductions. If you expect to claim deductions other than the standard deduction and want to reduce your withholding, use the Deductions Worksheet on page 3 and enter the result here4(b)

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

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