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ELECTRONIC SIGNATURE CONSENT

As part of the selection process at LaunchX, the "Company," you will need to consent to a background check electronically. By
typing your name and clicking in the box below, you are consenting to receive any communications (legally required or otherwise)
and all changes to such communications electronically. In order to use the website, you must provide at your own expense an
Internet connected device that is compatible with the minimum requirements outlined below. You also confirm that your device will
meet these specifications and requirements and will permit you to access and retain the communications electronically each time
you access and use the website.

System Requirements to Access Information

To receive and view an electronic copy of the Communications you must have the following equipment and software:

A personal computer or other device which is capable of accessing the Internet. Your access to this page verifies that
your system/device meets these requirements.
A current version of Chrome, Firefox, Safari, or Microsoft Edge Internet web browser which supports security industry
best practices for HTTPS encrypted communications, JavaScript, and cookies. Your access to this page verifies that
your browser meets these requirements.

System Requirements to Retain Information

To retain a copy, you must either have a printer connected to your personal computer or other device or, alternatively, the ability to
save a copy through use of a printing service or software such as Adobe Acrobat. If you would like to proceed using paper forms,
please choose option 2 below.

Withdrawal of Electronic Acceptance of Disclosures and Notices

You can also contact us to withdraw your consent to receive any future communications electronically, including if the system
requirements described above change and you no longer possess the required system. If you withdraw your consent, we will
terminate your use of the AccuSource HR website and the services provided through the AccuSource HR website.

To ensure that a signature is unique and to safeguard you against unauthorized use of your name, your IP address
(103.73.155.173) has been recorded and will be stored along with your electronic signature. Please note that if you wish to submit
your Disclosure and Authorization Forms electronically, AccuSource HR requires that you include your social security number or
user identification. All of your information will be encrypted and transmitted via our secure website.

CHOOSE ONE OF THE FOLLOWING OPTIONS:

I, [ Ansh Tiwari ] (type full name), consent to transacting electronically, including receiving legally required notices
electronically. I understand that AccuSource HR uses computer technology to ensure that my signed documents are not
altered after submission. I agree to allow AccuSource HR to validate my signed documents in this way.

I, [ ] (type full name), do not wish to electronically sign my documents. Rather, I

prefer to contact LaunchX for a printed background screening disclosure,

authorization, and questionnaire, which I will then provide directly to LaunchX. I
understand that I will NOT be able to access the electronic QuickApp invitation in
the email I received once I have opted out. I understand this may delay the
selection process with LaunchX.

[Submitted on Tue Dec 20 08:49:24 MST 2022 from address 103.73.155.173]

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I certify that I am an individual seeking prospective or continued employment to work in:

Employment country *
United States of America

Employment state *
New York
Employment county *
Albany

I certify that I am a resident of:

Residence country *
India

[Submitted on Tue Dec 20 08:52:17 MST 2022 from address 103.73.155.173]

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DISCLOSURE REGARDING
CONSUMER REPORT 

LaunchX, (the "Company,") may obtain one or more consumer reports about you for employment purposes, which may
include hiring, contract, assignment, promotion, reassignment, and termination. The "consumer reports" may include
information about your character, general reputation, personal characteristics, and mode of living.

The Company will obtain these consumer reports through AccuSource HR, a third-party consumer reporting agency.
AccuSource HR's address is 11811 N. Tatum Blvd., Suite 3031, Phoenix, AZ 85028. AccuSource HR's telephone number
is Phone: 951-734-8882 / 888-649-6272, Fax: 951-734-0884 / 888-649-6244 and its website is
http://www.accusourcehr.com.

In preparing the consumer report, AccuSource HR may investigate your education, work history, professional license and
credentials, references, address history, social security number validity, right to work, criminal record, lawsuits, driving
record and other information from public or private sources.

Acknowledgment
I acknowledge receipt of the DISCLOSURE REGARDING CONSUMER REPORT and certify that I have read and
understand this document.

[Submitted on Tue Dec 20 08:52:26 MST 2022 from address 103.73.155.173]

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DISCLOSURE REGARDING INVESTIGATIVE

CONSUMER REPORT

LaunchX, (the "Company,") may obtain one or more investigative consumer reports about you for employment purposes,
which may include hiring, contract, assignment, promotion, reassignment, and termination. An "investigative consumer
report" means a consumer report that includes personal interviews with your neighbors, friends, employers, or associates.
The investigative consumer reports may include information about your character, general reputation, personal
characteristics, and mode of living.

The Company will obtain these investigative consumer reports from AccuSource HR, a third-party consumer reporting
agency. AccuSource HR's address is 11811 N. Tatum Blvd., Suite 3031, Phoenix, AZ 85028. AccuSource HR's telephone
number is Phone: 951-734-8882 / 888-649-6272, Fax: 951-734-0884 / 888-649-6244 and its website is
http://www.accusourcehr.com.

You have the right to request additional disclosures and information about the nature and scope of an investigative
consumer report by contacting the Company. You also have the right to request a written copy of "A summary of Your
Rights Under the Fair Credit reporting Act" by contacting the Company.

Acknowledgment
I acknowledge receipt of the DISCLOSURE REGARDING INVESTIGATIVE CONSUMER REPORT and certify
that I have read and understand this document.

[Submitted on Tue Dec 20 08:52:31 MST 2022 from address 103.73.155.173]

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Para información en español, visite www.consumerfinance.gov/learnmore o escribe a la Consumer

Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.
A Summary of Your Rights Under the Fair Credit Reporting Act
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

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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.

You must give your consent for reports to be provided to employers. A consumer reporting
agency may not give out information about you to your employer, or a potential employer,
without your written consent given to the employer. Written consent generally is not required in
the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.
 
You may limit "prescreened" offers of credit and insurance you get based on information
in your credit report. Unsolicited "prescreened" offers for credit and insurance must include a
toll-free phone number you can call if you choose to remove your name and address from the
lists these offers are based on. You may opt out with the nationwide credit bureaus at 1-888-5-
OPTOUT (1-888-567-8688).
 
The following FCRA right applies with respect to nationwide consumer reporting agencies:

Consumers Have the Right To Obtain a Security Freeze

 
You have a right to place a "security freeze" on your credit report, which will prohibit a
consumer reporting agency from releasing information in your credit report without your
express authorization. The security freeze is designed to prevent credit, loans, and services from
being approved in your name without your consent. However, you should be aware that using a
security freeze to take control over who gets access to the personal and financial information in your
credit report may delay, interfere with, or prohibit the timely approval of any subsequent request or
application you make regarding a new loan, credit, mortgage, or any other account involving the
extension of credit.
 
As an alternative to a security freeze, you have the right to place an initial or extended fraud alert on
your credit file at no cost. An initial fraud alert is a 1-year alert that is placed on a consumer's credit
file. Upon seeing a fraud alert display on a consumer's credit file, a business is required to take steps
to verify the consumer's identity before extending new credit. If you are a victim of identity theft, you
are entitled to an extended fraud alert, which is a fraud alert lasting 7 years.
 
A security freeze does not apply to a person or entity, or its affiliates, or collection agencies acting on
behalf of the person or entity, with which you have an existing account that requests information in
your credit report for the purposes of reviewing or collecting the account. Reviewing the account
includes activities related to account maintenance, monitoring, credit line increases, and account
upgrades and enhancements.
 

You may seek damages from violators. If a consumer reporting agency, or, in some cases, a
user of consumer reports or a furnisher of information to a consumer reporting agency violates
the FCRA, you may be able to sue in state or federal court.
 
Identity theft victims and active duty military personnel have additional rights. For more
information, visit www.consumerfinance.gov/learnmore.
States may enforce the FCRA, and many states have their own consumer reporting laws. In some
cases, you may have more rights under state law. For more information, contact your state or local
consumer protection agency or your state Attorney General. For information about your federal
rights, contact:

TYPE OF BUSINESS: CONTACT:

1.a. Banks, savings associations, and credit unions with total a. Consumer Financial Protection Bureau
assets of over $10 billion and their affiliates 1700 G Street, N.W.
Washington, DC 20552
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b. Such affiliates that are not banks, savings associations, or
credit unions also should list, in addition to the CFPB: b. Federal Trade Commission: Consumer Response Center
600 Pennsylvania Avenue, N.W.
Washington, DC 20580
(877) 382-4357
2. To the extent not included in item 1 above: a. Office of the Comptroller of the Currency
Customer Assistance Group
a. National banks, federal savings associations, and federal 1301 McKinney Street, Suite 3450
branches and federal agencies of foreign banks Houston, TX 77010-9050

b. State member banks, branches and agencies of foreign b. Federal Reserve Consumer Help Center
banks (other than federal branches, federal agencies, and P.O. Box. 1200
Insured State Branches of Foreign Banks), commercial lending Minneapolis, MN 55480
companies owned or controlled by foreign banks, and
organizations operating under section 25 or 25A of the Federal c. FDIC Consumer Response Center
Reserve Act 1100 Walnut Street, Box #11
Kansas City, MO 64106
c. Nonmember Insured Banks, Insured State Branches of
Foreign Banks, and insured state savings associations d. National Credit Union Administration
Office of Consumer Financial Protection (OCFP)
d. Federal Credit Unions Division of Consumer Compliance Policy and Outreach
1775 Duke Street
Alexandria, VA 22314
3. Air carriers Asst. General Counsel for Aviation Enforcement & Proceedings
Aviation Consumer Protection Division
Department of Transportation
1200 New Jersey Avenue, S.E.
Washington, DC 20590
4. Creditors Subject to the Surface Transportation Board Office of Proceedings, Surface Transportation Board
Department of Transportation
395 E Street, S.W.
Washington, DC 20423
5. Creditors Subject to the Packers and Stockyards Act, 1921 Nearest Packers and Stockyards Administration area supervisor
6. Small Business Investment Companies Associate Deputy Administrator for Capital Access
United States Small Business Administration
409 Third Street, S.W., Suite 8200
Washington, DC 20416
7. Brokers and Dealers Securities and Exchange Commission
100 F Street, N.E.
Washington, DC 20549
8. Federal Land Banks, Federal Land Bank Associations, Farm Credit Administration
Federal Intermediate Credit Banks, and Production Credit 1501 Farm Credit Drive
Associations McLean, VA 22102-5090
9. Retailers, Finance Companies, and All Other Creditors Not Federal Trade Commission: Consumer Response Center
Listed Above 600 Pennsylvania Avenue, N.W.
Washington, DC 20580
(877) 382-4357

Acknowledgment
I acknowledge receipt of the Summary of Your Rights Under the Fair Credit Reporting Act (FCRA) and certify
that I have read and understand this document.

[Submitted on Tue Dec 20 08:52:45 MST 2022 from address 103.73.155.173]

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NEW YORK CORRECTION LAW ARTICLE 23-A

LICENSURE AND EMPLOYMENT OF PERSONS
PREVIOUSLY CONVICTED OF ONE OR MORE CRIMINAL
OFFENSES

Section 750. Definitions.

751. Applicability.

752. Unfair discrimination against persons previously convicted of one or more criminal offenses
prohibited.

753. Factors to be considered concerning a previous criminal conviction; presumption.

754. Written statement upon denial of license or employment.

755. Enforcement.

Section 750. Definitions. For the purposes of this article, the following terms shall have the following
meanings:
(1) "Public agency" means the state or any local subdivision thereof, or any state or local department,
agency, board or commission.

(2) "Private employer" means any person, company, corporation, labor organization or association which
employs ten or more persons.

(3) "Direct relationship" means that the nature of criminal conduct for which the person was convicted has
a direct bearing on his fitness or ability to perform one or more of the duties or responsibilities necessarily
related to the license, opportunity, or job in question.
(4) "License" means any certificate, license, permit or grant of permission required by the laws of this state,
its political subdivisions or instrumentalities as a condition for the lawful practice of any occupation,
employment, trade, vocation, business, or profession. Provided, however, that "license" shall not, for the
purposes of this article, include any license or permit to own, possess, carry, or fire any explosive, pistol,
handgun, rifle, shotgun, or other firearm.

(5) "Employment" means any occupation, vocation or employment, or any form of vocational or
educational training. Provided, however, that "employment" shall not, for the purposes of this article,
include membership in any law enforcement agency.

Section 751. Applicability. The provisions of this article shall apply to any application by any person for a
license or employment at any public or private employer, who has previously been convicted of one or
more criminal offenses in this state or in any other jurisdiction, and to any license or employment held by
any person whose conviction of one or more criminal offenses in this state or in any other jurisdiction
preceded such employment or granting of a license, except where a mandatory forfeiture, disability or bar
to employment is imposed by law, and has not been removed by an executive pardon, certificate of relief
from disabilities or certificate of good conduct. Nothing in this article shall be construed to affect any right
an employer may have with respect to an intentional misrepresentation in connection with an application
for employment made by a prospective employee or previously made by a current employee.

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Section 752. Unfair discrimination against persons previously convicted of one or more criminal
offenses prohibited. No application for any license or employment, and no employment or license held by
an individual, to which the provisions of this article are applicable, shall be denied or acted upon adversely
by reason of the individual's having been previously convicted of one or more criminal offenses, or by
reason of a finding of lack of  "good moral character" when such finding is based upon the fact that the
individual has previously been convicted of one or more criminal offenses, unless:

(1) There is a direct relationship between one or more of the previous criminal offenses and the specific
license or employment sought or held by the individual; or
(2) the issuance or continuation of the license or the granting or continuation of the employment would
involve an unreasonable risk to property or to the safety or welfare of specific individuals or the general
public.

Section 753. Factors to be considered concerning a previous criminal conviction; presumption. 1.

In making a determination pursuant to section seven hundred fifty-two of this chapter, the public agency or
private employer shall consider the following factors:

(a) The public policy of this state, as expressed in this act, to encourage the licensure and employment of
persons previously convicted of one or more criminal offenses.
(b) The specific duties and responsibilities necessarily related to the license or employment sought or held
by the person.

(c) The bearing, if any, the criminal offense or offenses for which the person was previously convicted will
have on his fitness or ability to perform one or more such duties or responsibilities.

(d) The time which has elapsed since the occurrence of the criminal offense or offenses.

(e) The age of the person at the time of occurrence of the criminal offense or offenses.
(f) The seriousness of the offense or offenses.

(g) Any information produced by the person, or produced on his behalf, in regard to his rehabilitation and
good conduct.

(h) The legitimate interest of the public agency or private employer in protecting property, and the safety
and welfare of specific individuals or the general public.
2. In making a determination pursuant to section seven hundred fifty-two of this chapter, the public agency
or private employer shall also give consideration to a certificate of relief from disabilities or a certificate of
good conduct issued to the applicant, which certificate shall create a presumption of rehabilitation in regard
to the offense or offenses specified therein.

Section 754. Written statement upon denial of license or employment. At the request of any person
previously convicted of one or more criminal offenses who has been denied a license or employment, a
public agency or private employer shall provide, within thirty days of a request, a written statement setting
forth the reasons for such denial.

Section 755. Enforcement. 1. In relation to actions by public agencies, the provisions of this article shall
be enforceable by a proceeding brought pursuant to article seventy-eight of the civil practice law and rules.
2. In relation to actions by private employers, the provisions of this article shall be enforceable by the
division of human rights pursuant to the powers and procedures set forth in article fifteen of the executive
law, and, concurrently, by the New York city commission on human rights.

NOTICE REGARDING CONSUMER REPORTS AND/OR

INVESTIGATIVE CONSUMER
REPORTS PER NEW YORK LAW
With your permission and in accordance with New York General Business Law Section 380, LaunchX, the "Company,"
may request a consumer report and/or an investigative consumer report about you from a third-party consumer reporting
agency in connection with your employment or application for employment. An "investigative consumer report" is a
background report that includes information from personal interviews. The most common form of an investigative
consumer report in connection with your employment is a reference check through personal interviews with sources such
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as your former employers and associates, and other information sources. If the purpose of the investigative consumer
report is for non-employment purposes, including but not limited to becoming a volunteer, vendor, independent contractor,
student enrollee, or student intern, we may investigate the information claimed by you during the interview and selection
process, including any documentation that you have provided, and interviewing people who are knowledgeable about
you. The investigative consumer report may contain information concerning your character, general reputation, personal
characteristics or mode of living. You may request more information about whether or not a consumer report and/or an
investigative consumer report was requested, as well as information on the nature and scope of an investigative
consumer report, if any, by contacting the Company in writing.

You have the right to inspect and receive a copy of any investigative consumer report requested by the Company, upon
its completion, by contacting the following consumer reporting agency:

AccuSource HR
11811 N. Tatum Blvd., Suite 3031, Phoenix, AZ 85028
Phone: 951-734-8882 / 888-649-6272, Fax: 951-734-0884 / 888-649-6244
http://www.accusourcehr.com

Acknowledgment
I acknowledge receipt of the NEW YORK CORRECTION LAW ARTICLE 23-A, and the NOTICE REGARDING
CONSUMER REPORTS AND/OR INVESTIGATIVE CONSUMER REPORTS PER NEW YORK LAW and certify
that I have read and understand this document.

[Submitted on Tue Dec 20 08:52:53 MST 2022 from address 103.73.155.173]

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AUTHORIZATION FOR CONSUMER AND/OR INVESTIGATIVE

CONSUMER REPORT
I acknowledge that, as a condition of employment or continued employment, LaunchX, (the
"Company") may, now or any time during my employment with Company, obtain a consumer
report about me, as applicable and to the extent permitted by law. The consumer report may
include verification of my education, previous employment/work history, credit history, motor
vehicle records, verification from personal references, drug testing, criminal history located in the
files of any Federal, State, or Local criminal justice agency, and verification of any other
information deemed necessary by Company. The results of this consumer report will be used to
determine employment eligibility under Company's employment policies. I acknowledge that if
information from the report is used in whole or in part in taking adverse action with regard to my
potential or continued employment, before taking the adverse action, Company will provide me
with a copy of the consumer report and a copy of "A Summary of Your Rights Under the Fair
Credit Reporting Act."
I authorize AccuSource HR, a third-party consumer reporting agency, and any of its agents, to
disclose orally and in writing the results of the consumer report to the designated authorized
representative of Company.  AccuSource HR is located at 11811 N. Tatum Blvd., Suite 3031,
Phoenix, AZ 85028, has a phone number of Phone: 951-734-8882 / 888-649-6272, Fax: 951-
734-0884 / 888-649-6244 and website of http://www.accusourcehr.com.
I authorize persons, schools, current and former employers, and other organizations and
agencies to provide AccuSource HR with all information that may be requested. I agree that any
copy of this document is as valid as the original. According to the Federal Fair Credit Reporting
Act, I am entitled to know if employment was denied based on information obtained by my
prospective employer and to receive a disclosure of the public record information and of the
nature and scope of the investigative report.
I understand that typing my name and the last four digits of my Social Security Number or User
PIN, and clicking on the "Sign Acknowledgment" button below, constitutes my electronic
signature, dated as of when I click on the "Sign Acknowledgment" button, and that by doing so:
I have read, understand, and acknowledge the receipt of the applicable disclosures and authorization
I am authorizing Company to obtain the consumer report and/or investigative consumer report
I am authorizing AccuSource HR to prepare the consumer report and/or
investigative consumer report described above
I am consenting to use electronic means to sign this form and have read and understand the above disclosure
I acknowledge I may request a hard copy of this Disclosure and Authorization form after agreeing to the
background check electronically by calling AccuSource HR at Phone: 951-734-8882 / 888-649-6272, Fax:
951-734-0884 / 888-649-6244

Agreement

I agree: [ Ansh Tiwari ] Last 4 of your social security number / user PIN [ 0000 ]
Please note: the last four digits of your SSN or user PIN may be required at a later time for verification purposes.

[Submitted on Tue Dec 20 08:53:07 MST 2022 from address 103.73.155.173]

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DECLARATION, AUTHORIZATION AND RELEASE FOR BACKGROUND INFORMATION - APPLICANTS FOR

EMPLOYMENT

To research, verify and provide a report to LaunchX ("Company") in relation to the information that I have provided in
connection with my application for employment, the Company will engage a background screening provider,
AccuSource HR ("Provider"). The information Provider and its agents may verify and research may include my
personal background, professional standing, work history and qualifications. The Company and its representatives
may also collect and verify background information about me.

I understand that the pre-employment screening searches, to the extent applicable law allows and in accordance with
applicable laws, will be conducted and information I provide will be researched and verified using various appropriate
sources, including but not limited to the following: current and past employers, criminal conviction records, motor
vehicle or driving records, credit information, military records, school/educational records and professional and
personal references.

I authorize, without reservation, any individual, corporation or other private or public entity to provide the Company and
Provider and their representatives all relevant information about me.

I agree to assist Provider and the Company and their representatives in verifying and collecting this information and to
provide any additional information requested in connection with my application for employment with the Company.

Unless I submit my revocation to the Company this Declaration, Authorization and Release, in original, faxed or
photocopied form, shall be valid for this and any future reports and updates that may be requested if I am employed by
Company.

Data Privacy Laws around the World

Many countries around the world have laws to protect 'personal data'; that is, information about identified or identifiable
individuals. In the course of researching and verifying information from the sources described above, Provider and the
Company will process personal data, some of which may have a high degree of sensitivity. However, both Provider
and its agents are familiar with and make every effort to comply with all applicable data privacy laws, including, in
particular, the European Union's General Data Protection Regulation ('GDPR').

With respect to GDPR, please be aware of the following companies and their roles:

          Company is a data controller (as defined under GDPR)

          Provider is a data processer
            Provider's agents are data processers

Company, AccuSource HR and its agents are independent data controllers (not joint controllers), each with their own
respective legal responsibilities with respect to their processing of personal data.

As described above, Company, Provider and its agents will process my personal data for pre-employment background
screening and related purposes. The report produced by Provider and its agents will generally contain personal data
about me, and it is shared with the Company.

For the purposes of GDPR, Provider and its agents process my personal data on the basis that it is necessary for the
purposes of the legitimate interests pursued by Company, Provider and its agents. The legitimate interests of Provider
and its agents include the provision of a pre-employment backgrounding checking services to commercial
organisations to ensure the suitability, integrity and reliability of individuals such organisations wish to employ in
positions of responsibility where such personal qualities are important.

I explicitly consent to Provider, its agents and Company processing personal data for the purposes described above. I
also explicitly acknowledge that the nature and circumstances of my proposed role with Company are such that it is of
the utmost importance for Company, Provider and its agents to conduct the pre-employment screening described
herein and that, as such, my consent, including in relation to the processing of sensitive personal data, is freely-
given.Depending on my career history, personal circumstances and the nature and location of the role for which I am
being considered, it may be necessary for Provider and its agents to obtain personal data about me from various
countries around the world and, in order to do so, to share certain of my personal data with its network of contractor
researchers in these countries. I understand that such researchers are bound by strict contractual obligations of
confidentiality and data privacy when it comes to the handling of my personal data.

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12/20/22, 9:26 PM Applicant Authorization Forms
AccuSource HR is a member of the US Privacy Shield, a European Commission approved programme intended to
protect the personal data of European citizens when it is transferred to the United States. I may review its US Privacy
Shield certification here:

https://www.privacyshield.gov/participant?id=a2zt00000008W13AAE&status=Active

Once the report has been compiled and provided to Company, my personal data is deleted from AccuSource HR's
systems after a minimum of 3 years unless otherwise provided in a contract between Company and AccuSource HR.

I have certain rights in respect of my personal data, including the right to access, correct, and to request the erasure of
my personal data.

Provider will comply with any requests to exercise my rights in accordance with applicable law. I am aware, however,
that there are a number of limitations to these rights, and there may be circumstances where Provider is not able to
comply with my request. To make any requests regarding my personal data, or if I have any questions or concerns
regarding my personal data, I should contact Provider using the details below. Depending on the country in which I am
located, I may also be entitled to contact my local supervisory authority for data protection.

If I have any queries on any aspect of AccuSource HR's Privacy Policy, I can contact AccuSource HR's Data Protection
Officer by email at [email protected] or by post at the address below.

AccuSource HR
Attention: Data Protection Officer
11811 N. Tatum Blvd., Suite 3031, Phoenix, AZ 85028

Agreement

I agree: [ Ansh Tiwari ] Last 4 of your social security number / user PIN [ 0000 ]
Please note: Input the last four digits of your SSN. If you do not have a SSN, create a 4 digit PIN which may be required at a later time
for verification purposes.

[Submitted on Tue Dec 20 08:53:33 MST 2022 from address 103.73.155.173]

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