I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
I,Name* , hereby acknowledge and agree to authorize Resource Production Co., Inc. to conduct a Motor Vehicle Records check by obtaining a report of my driving history for Resource Production Co., Inc. use in determining if I will be offered employment and/or continue my employment. If I am employed in a position that requires driving, I further authorize Resource Production Co., Inc. to conduct Motor Vehicle Record Checks as long as I am employed and in a position requiring me to drive. I understand that in obtaining such reports, a consumer reporting agency may be used and I do hereby authorize such use. I further acknowledge and agree that the reports may be procured by Resource Production Co., Inc. insurance agency, Kysar Millennium Leavitt Insurance, to provide an assessment of my insurability under Resource Production Co., Inc. insurance coverages. I understand that by signing this Authorization, I hereby authorize Resource Production Co., Inc. to procure such reports about me from time to time, as it deems appropriate, from any state or jurisdiction that I have been licensed to drive motor vehicles and to share this information with Resource Production Co., Inc. insurance carrier, in order to evaluate my insurability.
The information provided on this form is collected solely for employment screening and insurance underwriting purposes for Resource Production Co. All information will be stored securely and accessed only by authorized personnel.