In connection with my application for employment with as an Independent Contractor with Assembly Technicians Unlimited, I hereby authorize said company and any authorized agent acting on its behalf to prepare an investigative report on my background. I therefore authorize, request and require any persons or companies contacted to furnish Assembly Technicians Unlimited or its agents any information they have concerning any criminal and/or motor vehicle conviction records, my work history and achievements, education history and achievements, general reputation and character.

As an inducement to provide this information, I hereby release and forever discharge each and every such person or company from any and all claims of liability, in law or in equity that may arise out of furnishing such information to Assembly Technicians Unlimited or any authorized agent of that company.

I may, upon written request, receive further information as to the nature and scope of such investigation. Any inquiries are to be directed to the agency/company as listed in the two preceding paragraphs.