I certify that all statements made by me on this application are true and complete to the best of my knowledge and that I have withheld nothing that would, if disclosed, affect this application unfavorably. I understand that misrepresentation or omission of facts is cause for disqualification from further consideration for hire or for dismissal.

I authorize the references listed in this application, including personal and employment references, to provide Missouri Farm Bureau Federation & Affiliated Companies (MOFB) with all information pertinent to this application and I release all parties from liability for any damages that may result from the release of any information as a part of the employment verification process. In consideration for MOFB’s review of this application, I authorize investigation of all statements contained in this application. My cooperation includes authorizing MOFB to conduct, when requested, a pre-employment criminal history investigation. Additionally I authorize MOFB, in consideration for MOFB’s review of this application, to supply employment record, in the whole or in part, and in confidence, to any government agency, or other party, with a legal or proper interest.

I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between MOFB and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me, and I understand that no promise or guarantee is binding upon MOFB unless made in writing. Further, I understand that MOFB is an employment-at-will company, as such if employed; my employment is at will and that I have the right to terminate my employment at any time for any reason and that MOFB retains the same right. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of MOFB.

I understand and agree that in accordance with Federal Law, I must provide proof of identity and proof of eligibility to work in this country upon the event of employment.

In the absence of my handwritten signature, I understand that my submission of this application will serve as a written signature for purposes of this application.

This is to inform you that as part of our procedure for processing your employment application an investigative report may be made whereby information is obtained through professional references. This inquiry may include information as to your character, general reputation, personal characteristics and mode of living, whichever are applicable. You have the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of the investigation and report, if made.

By submitting this application form, I acknowledge that I am authorizing Missouri Farm Bureau Services, Inc., to obtain a full record check from a local police department or any other law enforcement agency or any credit reporting agency concerning my character, my general reputation, my personal characteristics and my mode of living. I understand that in the event the company decides to make checks or investigations that the information obtained may be used in deciding whether to offer me employment.