Free Response to Motion - District Court of Arizona - Arizona

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Identify Iny periods of time during which you were I\ot .mpl

or not .nendl"9 Khool during tM lut ten (10) ye'B.

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u.s. MILITAIn' AND OnfU
H... you It'rwd in tllp U S. .~

DATA to.,...? Wit..y 8lAntll D.w pntr..d

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C>od ou ...(pi". . cll~hono..bl. di~d'''9'? y

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T~ of di~chargf is onf fac10, lIt the selection proct'n and will not nece~~rily di~qualify itn applicant. Orcums1l1ncM surrounding tht' di~charge will be consrdt'rMi. ... you ever Men refu~d or cancelled from bonding cOYerag.? 0 nt, " 'V.I',lpIA,n: . No

.~ you .~, been convict.d of, ple.ded guiltyor, no .ndfor unresolYt'd charges or arrests should not be provided in states which r,nrict such .nquities.
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Y~5. If 'Yes'. fap/"n:

yp you bH'" chargPCIwith or a",strd for any crimi,..1 oHmse desui~d .bo", 'or which you are awaiting dispOsition, dismiu.-I. 1e'"';lI.>lion. fuT1hp, court prpcerding\ or . ftnal resolution11nclude .ny pending criminal c.St which has been postponed pursuant to . pre.t,i.. divff~ion or ~imilar progr.-n'-

~you MHwe,MI yes to .ither No 0 If

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question, plnse note that, where consistent with applicable law. . conviction or unresolved criminal cha'ge or ~rresl will not rtoWlt in ali automitt;c disqu.lification from employment Wh.r. .ppropri.te. factors such as ~Ie(s), natur., job relat.dMu and seriousn~t 01 th, offens," will be con5ider,d. However. plelS' be .dvised thllt the Federal DepoSit Insur.nc. Att provides ttwlt "...any PftSDn who has been convicted of any cuminal off,nse involVing dIShonesty or a br.ach of trust. or money laundering, or has 'IJrted to t'ntH into a pretria' diveBion or similar prog'''", in connte tlon with a pro~ecutlon of such offmst. m.y not... particlp11e, directly Of'indi~tly, in t~ conduct of the aff.irs of.ny !luured depository Institution..

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I understand and agree that my employmenl is subject to succ~ssful/y paning a review by a senior human resources executive regarding concurrent employment at Chase of relatives by blood, marriage or law. including a domestic partner. I ..Iso und(lrstand and agree thai my employment is subject to satisfactorily passing a drug screen and the successful completion of reference checks. I agree to h..vl' my fingerprints and photograph talen and that law enforcement agencies, including the FBI, will be contactl'd ..nd I agree thilt Cnase may conduct p05t.employment inVt'stigations. I understand that if I accept an otfer of .mployment, past employe~rduc..tior'lal institutions and/or the military may be cont..cled for references, and I hereby authorize such inquiries, agree that this applic.tion may be used in such inquiriM and agrel' that I will sign any ~ct-ssary 't-Iease ituthor;z;ng such t-ntitit-s 10 provide Chast- with my comp'ett- emp'oymrnt. education andlor military background, inc:JudinSi information and opinions r~ardin9 my character, ability. performance, att.ndance, punctuality, conduct, and reason for termination. I understand and agree that, consistent with .pplicable law, I im obligated to immediately inform Chase and update any information intfudlng Clnypending cnminal uses, criminal conviction~, or guilty plpas. no contest to, and entry into pretrial diversion or SlmilM program concerning prosecution for a criminal offense, and that f.ilure to do so may result in disqualification of my application or tl"min~tlon of my employment whenever discovered,

I understand 1hat nOlhingcontained in this employment application is intended to lead to or creale an employment conlract between Chase and me. Ifurther understand and agree that the employment relationship that may result from my application will be an employmel.t-at-will, and eilher I or Chase may terminate my employment at any time for any rl'ason or for no reason and with or without notice. I undeBtand that no employ('l'(includingany oHicer)of Chase has the authority to alter the employment-at-witlrelationship,.orally,or In writing I further agree that I am subject to and will follow Chase's policiesand procedures, including. but not limited to, Chase's Code of Conduct ..nd Itny responsibilitiesset forth in Chase's employee handbook (e.g., 'Working T09,ther . Your Guidl' to Human R~ources Policies:) I ur'\de~titnd that Chase's policies and procedures .ne guidelines and shall not be consider.d to impose any contrictual obligations on Cha~e I further under~tand that Chasemay chang. its policiesand procedurl's without notice to or consent by its employees.
'certify Ihat the statl-ments made in this application are true and com~ct to the best of my Icnowledgt' and I understand and 119r~ that any misstatement or omission of fact, or failure to timely providp verification of information provided on .ne applicoJlion well r~sult in disqualifica~of "1Yapplicalion or termination of my employment whenl'Ver discovered.

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CBSOO0107

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Case 2:02-cv-02157-SRB Document 78-3 Filed 07/17/2006 Page 1 of 2

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Chase Employrmnt Appliaijon Ridc,

Dw Prospecuve Applicant:
If foU arc l;ompkUn: LhisappliQlion to work ill one: of the Ilo1teslisted below, plC4SC 'C;I<.I following illror"l;llj~n the

and si,,) anddale'hil fonn,
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TIu::following d\o1r1 lists various SIO)lCl haveccrt.-uu thilil rcslridiolU rclaOIl&: 10inquiriesconccrning criminal his10ry

pre- or post-trialwvcrsionprOCJ'1.lt1llndonvictionsof rnisd:'"C3I,ors). If I.hcslalc in which}'O\l :lrl: c

ftpplrillC ror c,nl.loymcn.11:JI a rC$l1ieuo". you slaould not pI'OvicJc infornuuon :is checked below. tJ.c

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Slitlc Pcuwng UnrcsolvW Arrests Rcconb of Pre- or PostTrial Conviction for Diversions MiaJcmc::allor s or SUlIlInary OlTcl\$Cl. filii Conviction cf CCJ1iUn Misdcmc:u,of1) or Complclion of Inc:arc;c:nLion Periw lOr
any MiscJcII1Co1noro

Convictioil Which Occurred Five or M.>rc YQf5 Prior '0 AppliQliou D;a.

Any MiI:I\Ic.a"or Conviction for Which P.t'!>;,t;on 11.15 ccn U Succcssfully COlllplckd or Ol1lc,.",isc Dis<:h;uScd ;IIId thc CilSCh,u bcc Dismissed Judicially.

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C:tlt inquire .,bout iIIIlVra\ £Orwl,iclt Liteapplic3I'1 is oul on bailor on .,islber own reco;nil.;lIlCc pending Ili;I' C.III incluifl:only :u to p:nding felony charges. CI:Ji;\in luiW!:1\Ic:anorsinclude: I.Irwtkcnncss. simple 3~ult Ipccdin~ Ihillor IrJDic vioialiulls. "rrr:I)'. all\! uilhu~~c or Ihc peace. 'n,;, I:nvolllyapplies 10i"[filClioltlror pos.sr:.s.sion insubstantial amounU of n~rijll;II\.,. 110110 of cOllvictions uf poIIc.5Iion ror ,;v;c: amounU of Ihe dru& distribution or possession, :ul\J distributioll ur 11I;lIIu(;,,,"rcor olhl:I dru~ sucb as cocaille..

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Case 2:02-cv-02157-SRB Document 78-3

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Filed 07/17/2006

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