I hereby certify that the foregoing statements are true, and hereby authorize investigation of all the statements contained in this records. I understand thatmisrepresentation or omission of fact called for in this form is sufficient cause for summary separation from the company's service if employed. Further that ifemployed, I agree to abide by all the company's rules and regulations.

I further understand and agreed that if employed, my appointment will be on temporary basis for a period at the discretion of the company and subject tosatisfactory work otherwise, I shall be dismissed without further reason and without liability on the part of the insurance.

I also acknowledge the obligation refrain from divulging any confidential information I may acquire during the course of my employment with the Company.

I understood clearly that this is only an application and not a guarantee of any employment.

I am also willing to undertake upon request by the company to do the following:

1. Submit myself to medical and physical examination by the Company's doctor

2. And other things which may be required of me.

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