The information contained in this authorization is true and complete to the best of my knowledge.

I hereby authorize Able Personal Care, Inc. and its designated agents and representatives to conduct a comprehensive review of my background for employment and/or volunteer purposes. I understand that the scope of the report may include but is not limited to the following areas: verification of social security number, employment history, character and work references, drug testing, civil and criminal history records from any criminal justice agency in any and all federal, state, and county jurisdictions, and any other public records.

I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or written, pertaining to me to Able Personal Care, Inc. or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. Able Personal Care, Inc. and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including, but not limited to, addresses, social security numbers, and dates of birth. However, I understand that certain criminal offenses (convictions only) may have to be disclosed to my client before I am able to begin my employment. Able Personal Care Inc. will inform me of any information needing to be disclosed prior to releasing any information.