Authorization
Social Security Number Notice
Social security numbers (SSNs) are used to match individuals with their application/ examination file. Disclosure of your SSN is voluntary; however, a nine-digit number is necessary to process your application. Upon appointment and pursuant to Section 5101.312 of the Revised Code and certain other laws and regulations, a request for an SSN is mandatory. Your SSN may be used for purposes including but not limited to the following: identification of obligors under child support orders, detection of welfare fraud, processing of background checks and tax information, or general employee information.
Certification
I hereby affirm that my answers to these statements and questions are true and correct to the best of my knowledge. I have not knowingly withheld any facts or circumstances that would, if disclosed, affect my application unfavorably. I understand if this application is not completed in its entirety, it will not be processed, and I will be automatically disqualified. I understand that any offer of employment is conditional upon proof of legal authorization to work in the United States as required by the Immigration Reform and Control Act.
If employed, I agree to engage in no outside activity which would involve a material conflict of interest with or which could reflect adversely on the Van Wert County Board of Commissioners or each duly elected appointing authority. I further understand this decision rests solely with the Board of Commissioners or with each duly elected appointing authority.
If employed, I agree to engage in strictest confidence any information concerning the Van Wert County Board of Commissioners, the duly elected appointing authorities, its insureds, and its Agents that may come to my knowledge.
In consideration of my employment, if I am employed, I agree to conform to the employment policies of the Van Wert County Board of Commissioners or the duly elected appointing authorities and understand that my employment and compensation can be terminated with appropriate notice, at any time, at their option or myself. I understand that completing this application of this employment application does not guarantee employment.
I understand that any misrepresentation, deception, or false statements made in this employment application may result in my not being considered for employment, and if not discovered until after my becoming employed, is grounds for, and may result in, my immediate termination.
I understand that I will be required to successfully complete a urinalysis for drug testing purposes and/or a blood alcohol test as a condition of my employment., as well as a criminal background check as may be indicated by law. By submitting this Employment Application, I hereby consent to either or both of said tests.
Van Wert County is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, or veteran status.
By signing below, I acknowledge that I have read, understand, and agree to the above statements.
