EMPLOYMENT APPLICATION

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POSITION OBJECTIVE Position Desired: Date Available to Work:

Type of Employment Desired: Location Preferences: Minimum Salary Desired:

Full-Time Part-Time

Minimum to maximum hours available weekly: Indicate Days and Hours Available:

Min: Max:

Monday: Tuesday: Wednesday: Thursday: Friday: Saturday:

Are you available to work overtime? Yes No

PERSONAL DATA Name: Last First MI

Present Address: Street City State Zip

May we contact you at your business? Phone #: Home Business Message YES NO ( ) ( ) ( )

Email:

New hires must produce proof of identity and employment eligibility upon hire in accordance with the Immigration Reform and Control Act of 1986. Applicants must be presently authorized to work in the United States.

Can you, upon employment, provide documented proof establishing your identity and eligibility to be legally employed in the United States?

Yes No

Are you 18 years of age or older?If not, CA requires you to furnish proper working documents.

Yes No

Have you ever applied or worked for California Members Title Insurance Company or LA Teacher’s title company? If yes, explain:

Yes No

Members of the same family/household may be employed by California Members Title Insurance Company; however, there are some restrictions.

Do you have any family/household members employed by California Members Title Insurance Company?

Yes No

If yes, list name(s) and department(s):

How did you learn about the position you are applying for?Employee: Agency:

Advertisement: Other:

Can you perform the essential functions of the position for which you are applying? Yes NoIf no, please explain:

Are you currently employed? If yes, may we contact your present employer before an offer is extended?

Yes No Yes No

If you accept an offer, California Members Title Insurance Company reserves the right to contact your current employer.

Page 1 of 1

Please read carefully before you sign this application.

To Applicant:We appreciate your interest in our company and are interested in your qualifications. In order to make the best possible match between your skills and experience and our requirements, we need a clear understanding of your background. This application will remain active for six (6) months. California Members Title Insurance Company is an equal opportunity employer.

Instructions:Please fill out all blanks carefully and completely. Resumes are not accepted in lieu of completed applications, but are gladly accepted and are considered as supplemental information. Attached additional sheets if required to fully answer any question.

For positions requiring driving, you may be required to produce appropriate documentation.

Do you have a valid driver’s license? Yes No Driver’s License Number State Exp. Date

Are you willing to travel locally? Yes No Do you have reliable transportation? Yes No Do you have required insurance coverage? Yes No

EMPLOYMENT DATA

Please fill out completely and do not indicate “refer to resume”. However, resumes are gladly accepted as supplemental information. List all current and former employment beginning with the most recent. Include military service and self-employment. California Members Title Insurance Company reserves the right to request proof of current/previous salary; such as a paycheck stub or W-2 form.

1. Employer: Supervisor’s Name/ Title

Address City State Zip Code Phone Number with Extension:( )

Title: Date (mo/yr): Base Salary: Commission/Bonus:

Beginning:

Ending:Job Duties:

Did you voluntarily terminate your employment? Yes No State reason for leaving:

2. Employer: Supervisor’s Name/ Title

Address City State Zip Code Phone Number with Extension:( )

Title: Date (mo/yr): Base Salary: Commission/Bonus:

Beginning:

Ending:Job Duties:

Did you voluntarily terminate your employment? Yes No State reason for leaving:

3. Employer: Supervisor’s Name/ Title

Address City State Zip Code Phone Number with Extension:( )

Title: Date (mo/yr): Base Salary: Commission/Bonus:

Beginning:

Ending:Job Duties:

Did you voluntarily terminate your employment? Yes No State reason for leaving:

4. Employer: Supervisor’s Name/ Title

Address City State Zip Code Phone Number with Extension:( )

Titles: Date (mo/yr): Base Salary: Commission/Bonus:

Beginning:

Ending:Job Duties:

Did you voluntarily terminate your employment? Yes No State reason for leaving:

* Please explain any gaps in employment during the past 10 years (Dates/Reasons):

EDUCATIONAL BACKGROUNDSchool Attended Location Major Studies Years Completed Degree ReceivedHigh School

1 2 3 4College/University

1 2 3 4Graduate School

1 2 3 4Business/Vocation

1 2 3 4

List all foreign languages spoken: List special licenses, certifications (e.g., CPA, real estate license):

PC Software (e.g., Word, Excel): Technology Systems (e.g., Unix, NT, CICS, COBOL):

Business ReferencesName Business Title Length of time known Phone Number

BACKGROUND DATA

California Members Title Insurance Company functions in a position of public trust and is governed by government regulations regarding convictions of crimes. Therefore, California Members Title Insurance Company will conduct an investigation regarding criminal records if considered for employment. Evidence of a conviction record is not necessarily a disqualification to employment; each case will be considered on its own merits. Fingerprinting and bondability; however, is a condition of employment.

Have you ever been convicted of or pled no contest to a misdemeanor or a felony (minor traffic and parking violations may be excluded) in connection with, but not limited to: theft, perjury; sale of drugs; embezzlement; rape; murder; assault, forgery; robbery or burglary, etc.? Yes

No

If yes, please explain (if you need more space, please attach additional page):

California Members Title Insurance Company and all other title companies are required by Federal and State regulations to be covered under an approved fidelity bond. As part of a California Members Title Insurance Company’s due diligence in evaluating the risk of prospective employees or directors, CUNA Mutual Group (Our Bond coverage provider) provides a service of checking current or prospective employees or directors against the names of people whom CUNA Mutual Group has taken action against in the past.

Have you ever been declined for a bond application or has your bond coverage ever been modified or revoked? Yes No

If yes, please explain (if you need more space, please attach additional page):

For reference checking purposes, have you used other names in previous employment or schooling? Yes NoIf yes, list names:

PERSONAL INTERESTSPlease tell us about yourself and your reasons for seeking employment with California Members Title Insurance Company.

APPLICANT’S STATEMENT & AGREEMENTApplicants are considered for all positions without regard to race, color, religion, sex, national origin, sexual orientation, citizenship status, veteran status, presence of a non-job medical condition or disability or any other legally protected status. The Americans With Disabilities Act (ADA) and Section 503 of the Rehabilitation Act of 1973 prohibit employment discrimination against qualified individuals with disabilities. Similarly, Section 402 of the Vietnam Era Veteran’s Readjustment Assistance Act of 1974 eliminated barriers to employment for veterans. California Members Title Insurance Company is covered under these laws and willingly complies with them. The information requested on this application will be used to determine your qualifications for the particular employment sought; however, California Members Title Insurance Company makes no commitment to employment.

In the event of my employment in a position with California Members Title Insurance Company, I will comply with all rules and regulations of the title company. I understand that California Members Title Insurance Company may request that an investigative consumer report be prepared, which may include information regarding my character, general reputation, police record, credit record, personal characteristics and mode of living. I may request that California Members Title Insurance Company disclose the nature and scope of the investigation requested by submitting a written request to Human Resources within 10 days after you complete the application. I understand that California Members Title Insurance Company may use an outside agency to conduct such background screenings. A conviction record will not necessarily preclude employment. Factors such as age at time of offense, seriousness and nature of the offense and subsequent rehabilitation will be taken into account. Some regulations, however, prevent a person who has been convicted of any criminal offense involving dishonesty or a breach of trust from serving as an employee of a financial institution.

I understand that I may be required to take other tests such as personality and honesty tests, prior to and during my employment. I understand that should I decline to sign this consent or take any of the above tests, my application for employment may be rejected or my employment may be terminated. I understand that bonding may be a condition of hire and continued employment.

I further understand that California Members Title Insurance Company may obtain Public Records about me as part of a background investigation and that I may waive my right to receive a copy of such Public Records by checking the box to the right [ ].

I further understand that the Company may contact my previous employers. I authorize those employers to disclose to the Company all records and information pertinent to my employment with them. In addition to authorizing the release of any information regarding my employment, I hereby waive any rights or claims I have or may have against my former employers, their agents, employees, and representatives, as well as other individuals who release information to the Company, and release them from any and all liability, claims, or damages that may directly or indirectly result from the use, disclosure, or release of any such information by any person or party, whether such information is favorable or unfavorable to me. I authorize the persons named herein as personal references to provide the Company with any pertinent information they may have regarding myself.

I hereby state that all the information that I have provided on this application or any other documents completed in connection with my employment, and in any interview is true and accurate. I have withheld nothing that would, if disclosed, affect this application unfavorably. I understand that if I am employed and any information provided to the Company is found to be false or incomplete in any respect, I may be dismissed.

While the title company hopes that employment disputes will not occur, the title company believes that where such disputes do arise, it is in the mutual interest of everyone involved to handle them pursuant to binding arbitration, which generally resolves disputes quicker than court litigation and with a minimum of disturbance to all parties involved. By entering into this agreement, the title company and I are waiving the right to a jury trial for all employment related disputes.

The title company and I hereby agree that any dispute with any party (including the title company’s affiliates, CUSOs, successors, predecessors, contractors, employees and agents) that may arise from my employment with the title company or the termination of my employment with the title company must be submitted for resolution by mandatory, binding arbitration. The arbitration requirement applies to all statutory, contractual and/or common law claims arising from employment with the title company including but not limited to claims arising under Title VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act, the Equal Pay Act of 1963, the California Fair Employment and Housing Act, the California Labor Code Section 44, et seq., 970 and 1050 et seq., the Fair Labor Standards Act and claims of defamation under California Civil Code Section 44, et seq. or common law. Both the title company and I shall be precluded from bringing or raising in court or another forum any dispute that was or could have been submitted to binding arbitration. This arbitration requirement does not apply to claims for workers’ compensation benefits, claims arising under ERISA (29 U.S.C. § 1001 et seq.) or provisional remedies under California Code of Civil Procedure Section 1281.8.

Binding arbitration under this Agreement shall be conducted in accordance with California Code of Civil Procedure Section 1280 et seq. The arbitration shall be conducted before a neutral arbitrator selected by both parties in accordance with California Code of Civil Procedure Section 1281.6 from (1) the American Arbitration Association Labor and Employment Arbitrators Panel; (2) Judicial Arbitration and Mediation Services, Inc.; or (3) Action Dispute Resolution Services. The arbitration shall observe and apply all rules of pleading, all rules of evidence, all rights to resolution of the dispute by means of motions for summary judgment, judgment on the pleadings, and judgment under California Code of Civil Procedure Section 631.8. Any dispute with any party which arises from my employment with the title company or termination of employment with the title company must be submitted to binding arbitration within the applicable statute of limitations prescribed by law. With the exception of a filing fee that shall not exceed the cost to file a comparable claim in state or federal court, the title company shall pay the fees and costs of the Arbitrator, and each party shall pay for its own costs and attorneys’ fees. However, the Arbitrator may award costs and or attorneys’ fees to the prevailing party to the extent permitted by law. The parties will be permitted to conduct discovery as provided by the California Code of Civil Procedure Section 1283.05. The arbitrator shall, within thirty days of the conclusion of the arbitration, issue a written opinion setting forth the factual and legal basis for his or her decision.

I understand and agree to this binding arbitration provision, and both I and the title company give up our right to trial by jury of any claim I or the Company may have against each other.

If hired, I agree as follows: My employment and compensation is terminable at-will, is for no definite period, and my employment and compensation may be terminated by either the Company (employer) or me at any time and for any reason whatsoever, with or without good cause.

This is the entire agreement between the Company and me regarding dispute resolution, the length of my employment, and the reasons for termination of employment, and this agreement supersedes any and all prior agreements regarding these issues. It is further agreed and understood that any agreement contrary to the foregoing must be entered into, in writing, by the President of the Company. No supervisor or representative of the Company, other than its President, has any authority to enter into any agreement for employment for any specified period of time or make any agreement contrary to the foregoing. Oral representations made before or after you are hired do not alter this Agreement.

If any term or provision, or portion of this Agreement is declared void or unenforceable it shall be severed and the remainder of this Agreement shall be enforceable.

IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK A COMPANY REPRESENTATIVE BEFORE SIGNING. I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE SAME.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE STATEMENT & AGREEMENT.

Signature Date

VOLUNTARY SELF-IDENTIFICATION To assist us in meeting government reporting requirements and better evaluating the effects of our selection process, applicants are requested (but not required) to complete this section. The data you provide will be used solely for research and statistical purposes. Your voluntary cooperation is appreciated.

DE

TAC

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Last First MI

Gender Date of Application Male Female

Position applied for:

Please mark the single race/ethnic category that best describes the group to which you belong. If you feel that more than one applies, mark the one that is most important to you.

White – All persons having origins in any of the original peoples of Europe, North Africa or the Middle East.Black – All persons having origins in any of the Black racial groups of Africa.Hispanic – All persons of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.Asian or Pacific Islander – All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent or the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands and Samoa.American Indian or Alaskan Native – All persons having origins in any of the original peoples of North America and who maintain cultural identification through tribal affiliation or community recognition.

Are you a person with a disability? Yes NoA person who has a physical or mental impairment which substantially limits one or more major life activities, has a record of such impairment or is regarded as having such an impairment.

Are you a Vietnam Era Veteran? Yes No

A person who served on active duty for a period of more than 180 days, any part of which occurred between August 5, 1964 and May 7, 1975, and was discharged or released from active duty other than a dishonorable discharge; or was discharged or released from active duty for a service-connected disability.

DISCLOSURE AND AUTHORIZATION REGARDING BACKGROUND INVESTIGATION FOR EMPLOYMENT PURPOSES

Disclosure

California Credit Union may request from a consumer reporting agency and for employment-related purposes, a “consumer report(s)” (commonly known as “background reports”) containing background information about you in connection with your employment, or application for employment, or engagement for services (including independent contractor or volunteer assignments, as applicable).

HireRight, LLC (“HireRight”) will prepare or assemble the background reports for California Credit Union. HireRight is located and can be contacted at 3349 Michelson Drive, Suite 150, Irvine, CA 92612, (800) 400-2761, www.hireright.com.

The background report(s) may contain information concerning your character, general reputation, personal characteristics, mode of living, or credit standing. The types of background information that may be obtained include, but are not limited to: criminal history; litigation history; motor vehicle record and accident history; social security number verification; address and alias history; credit history; verification of your education, employment and earnings history; professional licensing, credential and certification checks; drug/alcohol testing results and history; military service; and other information.

Authorization

I hereby authorize California Credit Union to obtain the consumer reports described above about me.

Applicant Name ________________________________

Applicant Signature ________________________________ Date

PLEASE PROCEED TO THE NEXT DOCUMENT ENTITLED:

“OTHER DISCLOSURES, ACKNOWLEDGMENTS & AUTHORIZATIONS REGARDING BACKGROUND INVESTIGATION FOR EMPLOYMENT PURPOSES”

OTHER DISCLOSURES, ACKNOWLEDGMENTS & AUTHORIZATIONS REGARDING BACKGROUND INVESTIGATION FOR EMPLOYMENT PURPOSES

Disclosures

Investigative Consumer Report:

California Credit Union may request an investigative consumer report about you from HireRight, LLC (“HireRight”), a consumer reporting agency, in connection with your employment, or application for employment, or engagement for services (including independent contractor or volunteer assignments, as applicable). An “investigative consumer report” is a background report that includes information from personal interviews (except in California, where that term includes background reports with or without information obtained from personal interviews), the most common form of which is checking personal or professional references through personal interviews with sources such as your former employers and associates, and other information sources. The investigative consumer report may contain information concerning your character, general reputation, personal characteristics, mode of living, or credit standing. You may request more information about the nature and scope of an investigative consumer report, if any, by contacting California Credit Union.

Ongoing Authorization:

If California Credit Union hires you or contracts for your services, California Credit Union obtain additional consumer reports and investigative consumer reports about you without asking for your authorization again, throughout your employment or your contract period, as allowed by law.

Additional State Law Notices:

Please see the “Additional State Law Notice” for California. A California disclosure and summary of your rights under California Civil Code Section 1786.22, and a copy of New York Article 23-A, are being provided to you separately.

Summary of Rights under the Fair Credit Reporting Act:

A summary of your rights under the Fair Credit Reporting Act is being provided to you separately.

Disclosure and Authorization to Obtain Information:

Please complete the Identifying Information for Consumer Reporting Agency section of this form, sign and date.

HireRight Privacy Policy:

Information about HireRight’s privacy practices is available at www.hireright.com/Privacy-Policy.aspx.