CERTIFCATION STATEMENT
I certify that all information given on this application is true and complete to the best of my knowledge.
I understand that any false statements or omission of facts will be sufficient reason for termination of employment.
I further authorize Platinum Suppplemental Insurance Inc. to make all necessary and appropriate investigations to verifty the information contained in this application and release from all liability or responsibility all persons, companies, corporations or schools supplying information. Finally, I understand that any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause, and that this application is not an offer or contract of employment.