Note: Before accepting the following statement, please review this application carefully to make certain that you have answered all the questions that apply to you.

I declare that this application presents, to the best of my knowledge, an accurate statement of the facts. I have no objection to the Company investigating any of these facts and agree to indemnify the Company against any liability, which might result in conducting such investigation. This authorization shall be valid for one year from this date.

I release from all liability and responsibility those parties supplying information to the Company and authorize the Company to use this information where its legal interest and/or obligations are involved or where there is a medical emergency regarding me.

I understand that the Company will protect the confidentiality of any personal records regarding me. Consequently, personal information, other than the fact and location of past or present Company employment, the dates of employment, or the job name of general duties, will not be disclosed outside the Company without my consent, or as otherwise required by law.

I understand that misrepresentation or omission of any fact requested or in any other statements made in my request for employment will be sufficient cause for dismissal from the Company's service if I shall have been employed.

If employed by Prudential ACS Real Estate, I agree to abide by its rules and regulations. Further, I understand that my employment is not for a stated period and that I have the right to terminate my employment at any time and that Prudential ACS Real Estate retains a similar right.