Form 001

Revised 06.23.16

Metro Property Services Employment Application

Metro Property Services is an Equal Opportunity Employer, dedicated to non-discrimination in employment including, but not limited to age, sex, color, race, creed, national origin, religion, marital status, sexual orientation, or disability. The company reserves the right not to consider applications that have incomplete information, or that are received without necessary certifications, licenses, or other required documents.

This application is valid for 90 days from the date completed.

Date / Social Security Number / Home Phone Number
First Name / Middle Name / Last Name
Street Address / City and State / Zip

Have you ever been convicted of a felony? Yes ___ No ___ Have you ever been convicted of a misdemeanor? Yes ___ No ___

Provide details of convictions (i.e., date of conviction, location, penalty). Use back page to provide additional information.

Providing this information will not necessarily exclude you from consideration of employment.

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Position Preferences:

For what position are you applying / kkkkkkkkkkkkkkkkkkkkkkkkk / Salary desired / $
How were you referred to Metro Property Services?

As a job requirement, Metro Property Services requires employees to (1) lift and/or carry items up to 100 pounds, (2) climb ladders, and (3) use or work with power tools. Is there anything that would prevent you from performing the requirements? Please circle one. Yes No

Working overtime (hours above regular 40-hour work week) and on the weekend is considered a condition of employment and refusal to accept it when reasonable notice has been given is cause for disciplinary action up to and including termination. Do you agree to work overtime and on the weekend as requested? Please circle one. Yes No

Employment Information

List your current or most recent employment first. Include work related relationships, military, and volunteer work.

Current Employer Name / Azaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
Phone Number/Address/City/State/Zip / Cccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccc
Supervisor’s Name/Title / Cccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccc
Position Title
Dates of Employment / Start Date / xxxxxxxxxxxxxx / End Date / xxxxxxxxxxxxxxxxxxx
Salary / $ / Per: / Hour / mm / Week / Month / Year
Reason for Leaving / bbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
May We Contact your Employer / Bbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
Previous Employer Name / Azaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
Phone Number/Address/City/State/Zip / Cccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccc
Supervisor’s Name/Title / Cccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccc
Position Title
Dates of Employment / Start Date / xxxxxxxxxxxxxx / End Date / xxxxxxxxxxxxxxxxxxx
Salary / $ / Per: / Hour / mm / Week / Month / Year
Reason for Leaving / bbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbb

Applicant Signature Page

Information Certification and Release

I certify that the information I have given on this application and other requested documentation is true and complete. I understand that if I misrepresent any information verbally or in writing, any employment offer made to me may be withdrawn or my subsequent employment with Metro Property Services may be terminated. Initial ______

At-Will Employment

I understand that employment with Metro Property Services is at-will and my employment has no specific term and may be terminated by Metro Property Services or me with or without notice. I acknowledge that this application is not an employment contract, nor can it be used to create one. I acknowledge that Metro Property Services has not made any promises or representations that differ from the at-will statement. Initial ______

Proof of Employment Eligibility and Identity

I understand that I must complete the Form I-9 and provide satisfactory documents to establish my identity and right to work in the United States no later than the first day of employment. Failure to do so will result in termination of employment. Initial ______

Reference Verification Release

I hereby authorize Metro Property Services to verify information contained on this application and/or other documentation provided as well as to contact any company, person, or educational institution I listed on this document and hereby release those companies, persons, or educational institutions to disclose any information regarding my qualifications for employment, including but not limited to, employment dates, job duties, salary, and personal attributes. I agree to release and hold harmless Metro Property Services employees, officers, as well as any company, person, or educational institution for all claims of defamation, libel, slander, negligence, or interference with contract or profession that may result from the disclosure of employment related information. Initial ______

Employment Reference Release

As I may use Metro Property Services as a future reference, I authorize, release, and hold harmless Metro Property Services by its sole discretion and judgment, to disclose any employment-related information that it may determine appropriate to any companies, persons, or educational institutions that I have authorized to contact Metro Property Services. I understand this includes, but is not limited to, employment dates, salary and employment histories, disciplinary actions, attendance records, and performance reviews. I release my former and prospective employers, their employees, officers, and affiliates from all liability from damages of whatever kind, which may result to family, my associates, because of their compliance with this authorization or me. I understand and agree that my signing this release shall not obligate the Company to release any particular or specific information, as any disclosure will be at the Company’s sole discretion. All releases will remain in effect unless and until I provide written notice to the Company withdrawing the release(s). Initial ______

Metro Property Services Drug Free Workplace

I acknowledge that I have received a summary of the Drug-Free Workplace Policy (DFWP) and a summary of the drugs, which may alter of affect a drug test. I understand that I must read and comply with the policy as a condition of employment. I further understand that the DFWP program may involve routine testing of urine and/or blood to determine the presence of illegal drugs. I understand that submission to drug and alcohol testing is a pre-employment requirement and once hired a condition of employment with Metro Property Services. I understand that as a condition of employment, I may be required to submit to drug or alcohol testing for the following reasons: random basis, reasonable suspicion, or work-related incidents/accidents. I further understand that (1) if I refuse to consent to testing, (2) if I refuse to authorize release of the test(s) results to Metro Property Services, or (3) if the test(s) result(s) establish a violation of Metro Property Services policies, the application process will be stopped or if hired, disciplinary action up to and including termination will result. By signing this form, I hereby release Metro Property Services the results of the test(s) to which I have consented. I further authorize Metro Property Services to discuss the results with medical personnel/physicians collecting the specimen, the testing facility, its directors, officers, agents, and employees responsible for administering the aforementioned test(s) or evaluating the results thereof and any of them herein and to use the test(s) results as a defense to any legal action to which I am a party. I release any testing facility/physicians that have tested me from any liability arising from a release of all results, written reports, medical records, and data concerning my test(s) to the appropriate officials at Metro Property Services. Initial ______

Receipt of Information

I release and agree to hold harmless any individual, company, business institution, or government agency from all liability with regard to furnishing information to Metro Property Services. I agree to release and hold harmless Metro Property Services from all liability with respect to the receipt of such information. Initial ______

Applicant or Employee Name / Applicant or Employee Signature / Date


Disclosure and Release Form for Background Checks

In connection with my application for employment (including contract or volunteer services) or application for tenancy with Metro Property Services Inc. at 3530 St. Augustine Road, Jacksonville, FL 32207, I understand consumer reports will be requested by you (“Company”). These reports may include, as allowed by law, the following types of information, as applicable: names and dates of previous employers, reason for termination of employment, work experience, reasons for termination of tenancy, former landlords, education, accidents, licensure, credit, etc. I further understand that such reports may contain public record information such as, but not limited to: my driving record, judgments, bankruptcy proceedings, evictions, criminal records, etc., from federal, state, and other agencies that maintain such records.

In addition, investigative consumer reports (gathered from personal interviews, as applicable, with former employers or landlords, past or current neighbors and associates of mine, etc.) to gather information regarding my work or tenant performance, character, general reputation and personal characteristics, and mode of living (lifestyle) may be obtained.

I hereby authorize procurement of consumer report(s) and investigative consumer report(s) by Company. If hired (or contracted), this authorization shall remain on file and shall serve as ongoing authorization for Company to procure such reports at any time during my employment, contract, or volunteer period. I authorize without reservation, any person, business or agency contacted by the consumer reporting agency to furnish the above-mentioned information.

This authorization is conditioned upon the following representations of my rights:

I understand that I have the right to make a request to the consumer reporting agency: Background Screeners of America (“Agency”), 18344 Oxnard Street, Ste. 101, Tarzana, CA 91356, telephone number 866-570-4949, upon proper identification, to obtain copies of any report furnished to Company by Agency and to request the nature and substance of all information in its files on me at the time of my request. The request includes the sources of information and the Agency, on Company’s behalf, to provide a complete and accurate disclosure of the nature and scope of the investigation covered by the investigative consumer report(s). The Agency will also disclose the recipients of any such reports on me which the Agency has previously furnished within the two year period for employment requests, and one year for other purposes preceding my request (California three years). I hereby consent to Company obtaining the above information from the Agency. I understand that I can dispute, at any time, any information that is inaccurate in any type of report with the Agency. I may view the Agency’s privacy policy at their website: www.wescreenusa.com

I have read and I understand this page. ______(Applicant initials)
□ / I understand that I have rights under the Fair Credit Reporting Act and I acknowledge receipt of the Summary of Rights.
Applicant or Employee Name / Applicant or Employee Signature / Date
Last Name, First Name, Middle Name / Zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
□ Please check box if you do not have a middle name.
Former Name/Alias / Zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
Date of Birth / Zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
Social Security Number / Zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
Email: / Zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz zz
Current Address / Zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
Previous Address
Driver’s License Number and State Issuing / Zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz


A Summary of Your Rights Under the Fair Credit Reporting Act

Para informacion en espanol, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA.

For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

·  You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.

·  You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:

·  a person has taken adverse action against you because of information in your credit report;

·  you are the victim of identity theft and place a fraud alert in your file;

·  your file contains inaccurate information as a result of fraud;

·  you are on public assistance;

·  you are unemployed but expect to apply for employment within 60 days.

In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.

·  You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.

·  You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.

·  Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.

·  Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.

·  Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need – usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.