By my signature below, I hereby voluntarily consent to and authorize Summersalt, LLC or its authorized representative, to obtain a background check to be used solely for employment-related purposes. Checks may include criminal history, sex offender registry, certification and licensing verification (if applicable), educational credentials, employment eligibility (Social Security number check), credit checks, employment checks and/or reference checks. I hereby authorize any Background and/or Credit Reporting Agency to release to Summersalt, LLC all information regarding any contacts, disposition, and/or credit data that I may have on file with such agency.

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.