Background Waiver

Have you ever been convicted of a crime or do you have any criminal charges pending against you?*
(Only answer "Yes" if the crime indicated has not been sealed, expunged, dismissed, or annulled by a court. Answering "Yes" to this question will not necessarily disqualify an applicant from employment)
- Yes
- No
Please provide specific information (dates/detail) of the circumstances of all incidents*
Please make sure your full name is entered exactly as it appears on your government-issued identification
First Name*
Middle Name*
Last Name*
Suffix
Phone Number*
Country*
State/Province*
Current Home Address*
City*
Zip Code*
I certify that all information above has been answered truthfully, accurately, and completely to the best of my knowledge. Furthermore, I understand that any incorrect or false statement or misinformation furnished by me, intended or otherwise, may subject me to discharge at any time.
By clicking here, the undersigned hereby accepts and acknowledges this signature as his/her valid signature for purposes of all executions requested and necessary herein. The undersigned agrees that this electronic signature is acceptable in process and accurately represents the undersigned's legal intent. Further, the undersigned, by clicking here, further agrees that this electronic signature is his/her signature in fact and is effective and binding upon the undersigned as though signed in person. The undersigned further releases and hold harmless UACL Logistics, LLC and all related Universal entities from any and all liability for any claims of fraud, misappropriation, forgery, breach of duty and contract or any other reason or cause related to the alleged misuse of this electronic signature.*
- I accept the Application Agreement
Applicant's Legal Signature*
Date*
For California, Minnesota, or Oklahoma applicants only:
- I request a copy of my consumer report be sent to the home address listed above.
CAPTCHA

Please make sure your full name is entered exactly as it appears on your government-issued identification

I certify that all information above has been answered truthfully, accurately, and completely to the best of my knowledge. Furthermore, I understand that any incorrect or false statement or misinformation furnished by me, intended or otherwise, may subject me to discharge at any time.