SS Employment Application – BAWP Version 1.1

Confidential Application

for Employment

1818 Mt. Diablo Blvd.Walnut Creek, CA 94596

Tel: (925) 988-0804 Fax: (925) 988-0897 www.safestorageusa.com

We appreciate your interest in Safe Storage Management Co. and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work

history will help us potentially place you in a position that meets your objectives and those of the Safe Storage. Qualified applicants are considered for all positions without regard to race,

color, religion, sex, national orientation, age, marital status, veteran status, gender identity, sexual orientation, or the presence of a non-job related medical condition or disability.

EQUAL OPPORTUNITY EMPLOYER

SS Employment Application – BAWP Version 1.1

Safe Storage Management Co. Hiring Process

Before being hired by Safe Storage Management Co., all new hire candidates undergo the following process prior to the start of a 90-day probation period for all new employees.

Application

Submit a completed application (and resume if one is available) in response to Safe Storage advertisement

Interview No. 1Hiring Manager conducts a telephone or one-on-one

qualifying interview

Interview No. 2Candidate visits Human Resources Manager at

Safe Storage’s Walnut Creek administrative office

Interview No. 3Second interview with two Safe Storage senior managers

and hiring manager

Interview No. 4Final interview with Safe Storage personnel

Employment OfferSubmission of Offer Letter to final candidate by Safe Storage

HireNew hire begins a 90-day probation period

SS Employment Application – BAWP Version 1.1

DATE OF APPLICATION

PERSONAL INFORMATION (FULL LEGAL NAME) LAST NAME FIRST NAME MIDDLE NAME SOCIAL SECURITY NUMBER

HAVE YOU EVER USED ANOTHER NAME? YES NO INDICATE ANY OTHER NAMES: ALIASES, MAIDEN NAMES, ETC.

HOME TELEPHONE NUMBER MOBILE TELEPHONE NUMBER E-MAIL ADDRESS

PRESENT STREET ADDRESS CITY STATE ZIP CODE

MAILING ADDRESS, IF DIFFERENT THAN PHYSICAL ADDRESS CITY STATE ZIP CODE

DRIVER’S LICENSE NUMBER (CA I.D. NOT SUFFICIENT) STATE EXPIRATION DATE DO YOU HAVE A CLEAN DRIVING RECORD? YES NO IF NO, PLEASE EXPLAIN

IF HIRED, ARE YOU ABLE TO PROVIDE PROOF YOU ARE LEGALLY ABLE TO WORK IN THE UNITED STATES?

YES NO

DATE OF BIRTH

EDUCATION, TRAINING, U.S. MILITARY SERVICE

TYPE OF SCHOOL NAME AND CITY OF SCHOOL NO. OF MONTHS AND/OR

YEARS COMPLETED DID YOU GRADUATE?GED, DIPLOMA, DEGREE, LICENSE,

CERTIFICATE RECEIVED, IF ANY MAJOR FIELD OF STUDY

HIGH SCHOOL

YES NO

TRADE / BUSINESS SCHOOL

YES NO

COLLEGE

YES NO

OTHER TRAINING (EXPLAIN)

YES NO

OTHER TRAINING (EXPLAIN)

YES NO

ARE YOU PRESENTLY TAKING ANY EDUCATIONAL COURSES? YES NO IF YES, WHAT AND WHERE?

HAVE YOU SERVED IN THE U.S. ARMED SERVICES? YES NO IF YES, INDICATE MILITARY DUTIES AND TRAINING

SPECIAL SKILLS

PLEASE INDICATE LANGUAGES OTHER THAN ENGLISH THAT YOU: SPEAK FLUENTLY READ WRITE

ARE YOU ABLE TO OPERATE A PERSONAL COMPUTER? YES NO IF YES, WHAT TYPES OF SOFTWARE CAN YOU USE WITH PROFICIENCY?

INDICATE OFFICE MACHINES YOU ARE ABLE TO OPERATE

SPECIFIC SKILLS AND TRAINING – WHAT KNOWLEDGE, SPECIAL SKILLS AND/OR INDIVIDUAL CAPABILITIES DO YOU HAVE WHICH ESPECIALLY PREPARE YOU FOR THE POSTION?

SS Employment Application – BAWP Version 1.1

SAFE STORAGE EMPLOYMENT POSITION FOR WHICH YOU ARE APPLYING SALARY AND BENEFITS DESIRED HAVE YOU EVER APPLIED FOR WORK AT SAFE STORAGE BEFORE?

YES NO IF YES, DATE AND POSITION APPLIED FOR

HAVE YOU EVER BEEN EMPLOYED BY SAFE STORAGE IN THE PAST? YES NO IF YES, GIVE DATES OF EMPLOYMENT

INDICATE NAMES OF FRIENDS OR RELATIVES EMPLOYED BY SAFE STORAGE

HOW DID YOU HEAR ABOUT THIS POSITION?

NEWSPAPER ADVERTISEMENT INTERNET ADVERTISEMENT FRIEND/RELATIVE REFERRAL EMPLOYEE REFERRAL OTHER, PLEASE EXPLAIN:

PLEASE STATE WHY YOU ARE INTERESTED IN THIS JOB, DESCRIBING ITS RELEVANCE TO YOUR LIFE EXPERIENCE, SKILLS AND PERSONAL QUALITIES

AVAILABILITY DATE AVAILABLE TO BEGIN WORK ARE YOU CURRENTLY EMPLOYED?

YES NO IF SO, MAY WE CONTACT YOUR EMPLOYER?

YES NO CAN YOU WORK OVERTIME?

YES NO

HOURS AVAILABLE TO WORK DAYS AVAILABLE TO WORK

M T W TH F S SU

TYPE OF WORK FOR WHICH ARE YOU APPLYING

PART-TIME FULL-TIME

DO YOU HAVE A PART-TIME OR EVENING JOB YOU INTEND TO CONTINUE? YES NO

IF YES, GIVE DETAILS

WE COMPLY WITH THE AMERICANS WITH DISABILITIES ACT AND CONSIDER REASONABLE ACCOMMODATION MEASURES THAT MAY BE NECESSARY FOR ELIGIBLE APPLICANTS TO PERFORM ESSENTIAL FUNCTIONS. ARE YOU ABLE TO PERFORM THE ESSENTIAL FUNCTIONS OF THE JOB FOR WHICH YOU ARE APPLYING WITH OR WITHOUT REASONABLE ACCOMMODATION? YES NO

ADDITIONAL INFORMATION PLEASE INDICATE ANY JOB-RELATED ORGANIZATIONS, CLUBS, PROFESSIONAL SOCIETIES, OR OTHER ASSOCIATIONS TO WHICH YOU BELONG (YOU MAY OMIT THOSE WHICH INDICATE YOUR RACE, RELIGIOUS CREED, COLOR, NATIONAL ORIGIN, ANCESTRY, SEX OR AGE)

HAVE YOU BEEN DISMISSED OR ASKED TO RESIGN FROM ANY POSITION? YES NO IF YES, PLEASE EXPLAIN, PROVIDING DETAILS, INCLUDING THE REASONS GIVEN FOR YOUR DISMISSAL.

HAVE YOU EVER BEEN CONVICTED OF A MISDEMEANOR OR FELONY? PLEASE DO NOT LIST THOSE CONVICTIONS WHICH HAVE BEEN SEALED, EXPUNGED, STATUTORILY ERADICATED, OR ANY OTHER DISMISSAL AND/OR DISCHARGE. A CONVICTION WILL NOT NECESSARILY DISQUALIFY YOU FOR EMPLOYMENT. YES NO IF YES, PLEASE EXPLAIN.

PERSONAL AND PROFESSIONAL REFERENCES

PLEASE LIST 4 NON-RELATIVES WHO ARE QUALIFIED TO COMMENT ON YOUR CAPABILITIES AND CHARACTER, INCLUDING AT LEAST ONE PROFESSIONAL REFERENCE

NAME TELEPHONE NUMBER RELATIONSHIP OCCUPATION NO. OF YEARS KNOWN

EMERGENCY CONTACT INFORMATION NAME TELEPHONE NUMBER E-MAIL

ADDRESS CITY, STATE ZIP CODE RELATIONSHIP

SS Employment Application – BAWP Version 1.1

EMPLOYMENT HISTORY

ACCOUNT FOR ALL EMPLOYMENT WITHIN THE LAST 7 YEARS, BEGINNING WITH YOUR CURRENT OR MOST RECENT EMPLOYER. INDICATE EXPERIENCE THAT YOU BELIEVE IS RELEVANT TO THE POSITION FOR WHICH YOU ARE APPLYING (E.G. VOLUNTEER EXPERIENCE, ETC.). ATTACH AN ADDITIONAL SHEET, IF NECESSARY.

COMPANY NAME DATE EMPLOYED FROM DATE EMPLOYED TO STARTING SALARY ENDING SALARY

ADDRESS CITY, STATE TELEPHONE NUMBER SUPERVISOR MAY WE CONTACT THIS EMPLOYER?

YES NO

JOB TITLE HOURS WORKED IS THIS YOUR CURRENT EMPLOYER?

YES NO

REASON FOR LEAVING

SPECIFIC JOB DUTIES

COMPANY NAME DATE EMPLOYED FROM DATE EMPLOYED TO STARTING SALARY ENDING SALARY

ADDRESS CITY, STATE TELEPHONE NUMBER SUPERVISOR MAY WE CONTACT THIS EMPLOYER?

YES NO

JOB TITLE HOURS WORKED REASON FOR LEAVING

SPECIFIC JOB DUTIES

COMPANY NAME DATE EMPLOYED FROM DATE EMPLOYED TO STARTING SALARY ENDING SALARY

ADDRESS CITY, STATE TELEPHONE NUMBER SUPERVISOR MAY WE CONTACT THIS EMPLOYER?

YES NO

JOB TITLE HOURS WORKED REASON FOR LEAVING

SPECIFIC JOB DUTIES

COMPANY NAME DATE EMPLOYED FROM DATE EMPLOYED TO STARTING SALARY ENDING SALARY

ADDRESS CITY, STATE TELEPHONE NUMBER SUPERVISOR MAY WE CONTACT THIS EMPLOYER?

YES NO

JOB TITLE HOURS WORKED REASON FOR LEAVING

SPECIFIC JOB DUTIES

COMPANY NAME DATE EMPLOYED FROM DATE EMPLOYED TO STARTING SALARY ENDING SALARY

ADDRESS CITY, STATE TELEPHONE NUMBER SUPERVISOR MAY WE CONTACT THIS EMPLOYER?

YES NO

JOB TITLE HOURS WORKED REASON FOR LEAVING

SPECIFIC JOB DUTIES

SS Employment Application – BAWP Version 1.1

PERIODS OF UNEMPLOYMENT

PLEASE ACCOUNT FOR ALL PERIODS OF UNEMPLOYMENT WITHIN THE LAST 7 YEARS, BEGINNING WITH YOUR MOST RECENT PERIOD OF UNEMPLOYMENT.

DATES UNEMPLOYED:

FROM TO REASON FOR UNEMPLOYMENT

DATES UNEMPLOYED:

FROM TO REASON FOR UNEMPLOYMENT

DATES UNEMPLOYED:

FROM TO REASON FOR UNEMPLOYMENT

PLEASE NOTE

INCOMPLETE OR INCORRECT INFORMATION COULD DISQUALIFY AN APPLICANT. ALL QUESTIONS MUST BE ANSWERED IN FULL. DO NOT INDICATE “REFER TO RESUME.” APPLICATIONS WITH THIS STATEMENT WILL NOT BE PROCESSED. PLEASE NOTE AN OFFER OF EMPLOYMENT IS CONDITIONAL UPON A PRE-EMPLOYMENT BACKGROUND CHECK, MEDICAL EXAM AND DRUG SCREEN TEST. THIS APPLICATION IS VALID FOR NINETY (90) DAYS FROM THE DATE OF YOUR SIGNATURE. A NEW APPLICATION MUST BE SUBMITTED AFTER 90 DAYS TO BE CONSIDERED FOR ADDITIONAL

JOB OPENINGS. WE ARE AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER, DEDICATED TO A POLICY OF NONDISCRIMINATION IN EMPLOYMENT ON THE BASIS OF RACE, COLOR, RELIGION, SEX,

NATIONAL ORIGIN, AGE, SEXUAL ORIENTATION, OR MENTAL AND/OR PHYSICAL DISABILITY. PROBATIONARY PERIOD: NEW EMPLOYEES WILL BE CONSIDERED TRIAL EMPLOYEES FOR AT LEAST 90 DAYS BEFORE ATTAINING REGULAR STATUS.

APPLICANT AUTHORIZATION AND GENERAL RELEASE

I HEREBY AUTHORIZE SSMCo. AND ADPSELECT (HEREIN KNOWN AS “AGENT”) TO REQUEST AND RECEIVE ANY AND ALL BACKGROUND INFORMATION ABOUT OR CONCERNING ME, INCLUDING BUT NOT LIMITED TO MY CRIMINAL HISTORY, CREDIT HISTORY (INCLUDING A CONSUMER REPORT UNDER THE FAIR CREDIT REPORTING ACT, 15 U.S.C. 1681, ET SEQ. [THE “ACT”]), DRIVING RECORD, EMPLOYMENT HISTORY, LANDLORD/TENANT HISTORY, CIVIL LISTINGS, EDUCATIONAL BACKGROUND, PROFESSIONAL LICENSE FROM ANY INDIVIDUAL, CORPORATION, PARTNERSHIP, LAW ENFORCEMENT AGENCY, INSTITUTION, SCHOOL, ORGANIZATION, CREDIT BUREAU, STATE BOARD, LICENSING AGENCY, AND OTHER ENTITIES INCLUDING MY PRESENT AND PAST EMPLOYERS. I FURTHER RELEASE AND DISCHARGE SSMCo. AND ITS AGENT ADPSELECT, AND ALL OF THEIR COMBINED SUBSIDIARIES, AFFILIATES, OFFICERS, EMPLOYEES, CONTRACT PERSONNEL OR ASSOCIATES, FROM ANY AND ALL CLAIMS AND LIABILITY ARISING OUT OF ANY REQUESTS FOR, OR RECEIPT OF, INFORMATION OR RECORDS PURSUANT TO THIS AUTHORIZATION, PROCUREMENT OF AN INVESTIGATIVE CONSUMER REPORT, AND UNDERSTAND THAT IT MAY CONTAIN INFORMATION ABOUT MY CHARACTER, GENERAL REPUTATION, PERSONAL CHARACTERISTICS, AND MODE OF LIVING, WHICHEVER ARE APPLICABLE. I UNDERSTAND THAT I HAVE THE RIGHT TO MAKE WRITTEN REQUEST WITHIN A REASONABLE PERIOD OF TIME TO THE ORIGINAL PROVIDER OF CONSUMER INFORMATION FOR ADDITIONAL INFORMATION CONCERNING THE NATURE AND SCOPE OF THIS INVESTIGATION. I ACKNOWLEDGE THAT I HAVE VOLUNTARILY PROVIDED THE ABOVE INFORMATION FOR EMPLOYMENT APPLICATION PURPOSES, AND I HAVE CAREFULLY READ AND UNDERSTAND THIS AUTHORIZATION.

SIGNATURE DATE

CONSENT FOR DRUG AND ALCOHOL SCREEN TESTING

I HAVE BEEN FULLY INFORMED BY SSMCo. OF THE REASONS FOR THIS URINE TEST FOR DRUG AND/OR ALCOHOL. I UNDERSTAND WHAT I AM BEING TESTED FOR, THE PROCEDURE INVOLVED, AND DO HEREBY FREELY GIVE MY CONSENT. IN ADDITION, I UNDERSTAND THAT THE RESULTS OF THIS TEST WILL BE FORWARDED TO SSMCo. AND BECOME PART OF MY RECORD. IF THIS TEST RESULT IS POSITIVE AND FOR THIS REASON I AM NOT HIRED, I UNDERSTAND THAT I WILL BE GIVEN THE OPPORTUNITY TO EXPLAIN THE RESULTS OF THIS TEST.

I HEREBY AUTHORIZE THESE TEST RESULTS TO BE RELEASED TO: NAME

SIGNATURE DATE

ACKNOWLEDGMENT

I HAVE READ AND UNDERSTAND ALL PROVISIONS OF THIS APPLICATION. BY SIGNING THIS APPLICATION, I HOLD SSMCo. HARMLESS FOR ANY RESULT OF SSMCo. QUESTIONING REFERENCES PROVIDED IN THIS APPLICATION. I HEREBY CERTIFY THAT THE ABOVEMENTIONED INFORMATION IS TRUE, COMPLETE AND CORRECT. I ACCEPT THAT, IN THE EVENT OF MY HIRE, ANY INFORMATION FOUND TO THE CONTRARY

MAY LEAD TO IMMEDIATE DISMISSAL. ALL RELEVANT INFORMATION TO ASSIST IN MY APPLICATION HAS BEEN DISCLOSED. I UNDERSTAND THIS APPLICATION DOES NOT REPRESENT A CONTRACT FOR EMPLOYMENT. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION AS MAY BE NECESSARY IN ARRIVING AT AN EMPLOYMENT DECISION. I CERTIFY THAT I HAVE BEEN GIVEN A GENERAL OVERVIEW OF DUTIES AND RESPONSIBILITIES OF THE POSITION FOR WHICH I HAVE APPLIED. I UNDERSTAND THAT NO REPRESENTATIVE FROM SSMCo. HAS ANY AUTHORITY TO ENTER INTO ANY SPECIAL AGREEMENT WITH ME, TO PROMISE AND/OR GUARANTEE MY EMPLOYMENT FOR

ANY SPECIFIC TIME PERIOD EITHER PRIOR TO COMMENCEMENT OF EMPLOYMENT OR AFTER I HAVE BECOME EMPLOYED, OR TO ASSURE ME OF ANY BENEFITS OR TERMS AND CONDITIONS OF EMPLOYMENT, OR TO MAKE ANY AGREEMENT CONTRARY TO THE AFOREMENTIONED.

SIGNATURE DATE

THANK YOU FOR YOUR INTEREST IN WORKING AT SAFE STORAGE! HAND DELIVER YOUR SIGNED APPLICATION TO A SAFE STORAGE MANAGER.

YOU WILL RECEIVE A RESPONSE IN REGARDS TO YOUR APPLICATION FROM A SAFE STORAGE REPRESENTATIVE WITHIN TWO WEEKS OF ITS SUBMITTAL.