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Full Time Part Time

1.2. Complete Drug Screening3. Scan I-9 Documents*4. Submit Badge Photo*5. Submit Completed Application6. Submit Driving Requirements*

Submit Pay Selection Form*

Name:Title:Date:Signature

THIS FORM MUST BE COMPLETED AND RETURNED TO PAYROLL PRIOR TO THE EMPLOYEE'S FIRST DAY OF WORK

Weekly Salary

Rate

Comments

Salary Employee

TaskRemember to…

Hourly Employee

Approved By

New Hire Payroll Form

Social Security NumberFacility

First Name Middle Name Last Name

Full Address

City State Zip Code

Phone Number Email Address

Yearly Salary

Date of Birth EEOC Ethnicity

Self-Service Language PreferenceGender: Male Female Prefer not to self-identify

Name of Emergency Contact Telephone Number Relationship (Optional)

Department Primary Supervisor

Employment StatusJob TitleFirst Day of Work

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

APPLICATIONFOR EMPLOYMENT

(PLEASE PRINT)

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

Position(s) applied for: Date of application:

How did you learn about us? ☐ Inquiry☐ News Advertisement

☐ Employment Agency ☐ Other: ___________________________

Last Name: First Name:

☐ Relative/Friend☐ Indeed

Middle Name:

Address Number Street City State Zip Code

Telephone Number(s) Social Security Number

Best time to contact you at home is: …………………………………………………….. ______________ AM PM

If you are under 18 years of age, can you provide required proof of your eligibility to work? …………………………………………………………. ☐ Yes ☐ NoHave you ever filed an application with us before? ……………..…………………………. ☐ Yes ☐ No

If Yes, give date: ___________________

Do any of your friends or relatives, other than spouse, work here? ………..………………. ☐ Yes ☐ NoAre you currently employed? ……………………………….………………………………. ☐ Yes ☐ NoMay we contact your present employer? ……………………………………………………. ☐ Yes ☐ NoAre you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? ……………………………………………. ☐ Yes ☐ No

Proof of citizenship or immigration status will be required upon employment

Date available for work ____________________

Are you available to work: Full-Time Part-Time Temporary

What is your desired salary range? _______________

(please indicate 1 2 3 shift) (please indicate Mornings Afternoon Evenings) (please indicate dates available ___/___/___ - ___/___/___

WE REQUIRE ALL EMPLOYEES TO PASS A BACKGROUND CHECK AND OBTAIN AN E-RAILSAFE BADGE. APPLICANTS WITH FELONY CONVICTIONS WITHIN THE LAST 7 YEARS, RELEASE FROM

INCARCERATION WITHIN THE LAST 5 YEARS, OR OPEN COURT CASES MAY NOT PASS THE BACKGROUND CHECK, AND AS SUCH WILL BE SUBJECT TO IMMEDIATE DISMISSAL.

☐ Facebook☐ LinkedIn

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

EDUCATION

Name And Address of School Course of Study Years Completed Diploma / Degree

Elementary School

High School

Undergraduate College

Graduate Professional

Other (Specify)

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Describe any specialized training, apprenticeship, skills and extracurricular activities.

Describe any job-related training received in the United States Military

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

EMPLOYMENT EXPERIENCE Start with your present job or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

Employer Dates Employed Work Performed From To

Address

Telephone Number(s)

Job Title Supervisor

Reason for Leaving

Employer Dates Employed Work Performed From To

Address

Telephone Number(s)

Job Title Supervisor

Reason for Leaving

Employer Dates Employed Work Performed From To

Address

Telephone Number(s)

Job Title Supervisor

Reason for Leaving

If you need additional space, please continue on a separate sheet of paper.

List professional, trade, business or civic activities and offices held. You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status.

_____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________

1.

2.

3.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

ADDITIONAL INFORMATION

Other Qualifications Summarize special job-related skills and qualifications acquired from employment or other experience.

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SPECIALIZED SKILLS (CHECK SKILLS/EQUIPMENT OPERATED)Production/Mobile

__ Terminal __ Spreadsheet Machinery Other (list) __ PC/Mac __ Word Processing ______________ _____________ __ Typewriter __ Shorthand ______________ _____________ WPM _____ WPM ____ ______________ _____________

.

State any additional information you feel may be helpful to us in considering your application. ________________________________________________________________________________________

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Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

Are you capable of performing in reasonable manner, with or without reasonable accommodation, the activities involved in the job or occupation for which you have applied? A review of the activities involved in such job or occupation has been given. ______ YES _______ NO

REFERENCES 1. (Name) Phone Number:

(Address)

Phone Number: 2. (Name)

(Address)

Phone Number: 3. (Name)

(Address)

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

APPLICANT’S STATEMENT

I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

_______________________________________________ ______________________________ Signature of Applicant Date

ADDITIONAL EMPLOYMENT REQUIREMENTS

A conditional offer of employment may be made to you based on the information provided in this application. If hired, continuation of employment will be contingent on successful completion of other employment requirements to include, not limited to: passing a background check; passing a drug screen; meeting our driving record requirements; passing state and federal employment requirements (such as being authorized under e-Verify).

Please be advised that failing any of the employment requirements listed in our employee handbook and/or corporate policies may result in disciplinary action up to and including discharge.

ADDITIONAL EMPLOYMENT QUESTIONS

Have you been vaccinated against the COVID-19 virus?

_______ Yes _______ No

Employee Pay Selection Form

You have multiple options to receive your pay, as listed below. Please review them and make your selection by initialing your choice and signing below.

_____ Initials

DIRECT DEPOSIT I select direct deposit for disbursement of my pay.

I hereby authorize my employer, Inter-Rail, to initiate deposits of my net pay into the account at the financial institution shown on the attached personal check (“Financial Institution”) and further authorize Financial Institution to credit the account indicated with the deposits. If funds to which I am not entitled are deposited to my account, I authorize debits from my account and the return of such funds. This authority is to remain in effect until Inter-Rail or Financial Institution has received notification from me of termination of such authorization in such time and such manner as to afford Inter-Rail and Financial Institution a reasonable opportunity to act on those instructions or until Inter-Rail or Financial Institution cancels the direct deposit arrangement.

I have attached a voided personal check.

Account Type: Checking Savings

_____ Initials

MONEY NETWORK SERVICE I select to use either of the following options:

Money Network Check. The Money Network Check (“Check”) is a paycheck that I can easily complete on or after each payday morning wherever I am, eliminating the need to pick up my paycheck, wait for it to be mailed, or pay for it to be cashed. The Check can be deposited into my personal bank account or cashed for free at Money Network check-cashing partners. There is no fee for using Money Network Checks.

Money Network Payroll Debit Card. The Money Network Payroll Debit Card (“Card”) provides a dependable, safe, optional, and convenient way to receive and access my pay on and after each payday morning with the following features: (i) eliminates the need to pick up my paycheck, wait for it to be mailed, or pay for it to be cashed; (ii) immediate, worldwide access wherever the VISA card is accepted for ATM cash withdrawals, bank-branch withdrawals, and store purchases (including “cash back”); (iii) money transfers to a personal or joint checking account; and (iv) free balance inquiries by phone. I am automatically eligible for the Card and there is no application or approval process. There is no monthly service charge for the Card as long as I am employed by Inter-Rail. Many Card transactions are free, but there are fees for other transactions, and Money Network Checks can be used to access funds free of charge. All of the transaction fees are listed in the Welcome Kit.

I authorize Inter-Rail to disburse my pay by direct deposit or Money Network Service (“Service”) according to the selection I initialed above. If I don’t make a selection within 2 days of employment, I agree that my pay will be disbursed using the Service. I understand that I can change my pay selection at any time in the future.

Signature

Full Name (Printed )

Date

Note that your initial Tax Setup for federal and state tax, where applicable, will be defaulted to Single/Zero. This will beupdated through your Paycom completion of your W-4 form, and can be changed at any time during your employment.By signing this form, I authorize my final wages to be paid via the pay selection option I have chosen. Whethervoluntarily or involuntarily separated from employment, I understand my final pay will be funded into the direct

deposit account or network bank card option indicated.

Inter-Rail Group, Inc. Employee Direct Deposit Enrollment Form

To enroll in Direct Deposit, simply fill out this form and give to your manager. Attach a voided check for each checking account - not a deposit slip. If depositing to a savings account, ask your bank to give you the Routing/Transit Number for your account.It isn’t always the same as the number on a savings deposit slip. This will help ensure that you are paid correctly.

Below is a sample check MICR line, detailing where the information necessary to complete this form can be found.

IMPORTANT! Please read and sign before completing and submitting. I hereby authorize Inter-Rail Management to deposit any amounts owed me, as instructed by my employer, by initiating credit entries to my account at the financial institution (hereinafter “Bank”) indicated on this form. Further, I authorize Bank to accept and to credit any credit entries indicated by INTER-RAIL MANAGEMENT to my account. In the even that INTER-RAIL MANAGEMENT deposits funds erroneously into my account, I authorize INTER-RAIL MANAGEMENT to debit my account for an amount not to exceed the original amount of the erroneous credit.

This authorization is to remain in full force and effect until INTER-RAIL MANAGEMENT and Bank have received written notice from me of its termination in such time and in such manner as to afford INTER-RAIL MANAGEMENT and Bank reasonable opportunity to act on it.

Employee Name: Social Security #:

Employee Signature: ______________________________________________ Date:

Account Information The last item must be for the remaining amount owed to you. To distribute to more accounts, please complete another form.

Make sure to indicate what kind of account, along with amount to be deposited, if less than your total net paycheck.

1. Bank Name/City/State:

Routing Transit #: Account Number:

□ Checking □ Savings □ Other I wish to deposit: $ or □ Entire Net Amount

2. Bank Name/City/State:

Routing Transit #: Account Number:

□ Checking □ Savings □ Other I wish to deposit: $ or □ Entire Net Amount

3. Bank Name/City/State:

Routing Transit #: Account Number:

□ Checking □ Savings □ Other I wish to deposit: $ or □ Entire Net Amount

Memo

|: 012345678|: 123456789” 0101

Routing/Transit # (A 9-digit number always between these two marks)

Check # (this number matches the number in the upper right

corner of the check – not needed for sign-up)

Checking Account #

MINIMUM EMPLOYMENT REQUIREMENTS

TO ALL INTER-RAIL EMPLOYEES:

AS A MINIMUM REQUIREMENT OF EMPLOYMENT YOU MUST:

Be able to prove that you are insurable by our insurance company by providing a current copy of your driving record. This means that you must maintain a valid driver's license. That license may be checked for any violations within the last three years and at random times during the course of your employment with the company.

IN ADDITION:

Any DWI or DUI violation charged against your license (including those posted prior to conviction, trial dates, etc.) will disqualify you from insurance coverage and will be cause for immediate termination.

If you receive more than four (4) violations within a three (3) year period, you will be disqualified from insurance coverage and will be cause for immediate termination.

All persons applying for employment with the company must submit to a drug screen test to be performed at an approved testing clinic, hospital, etc., as designated by the company.

NOTE: Employees are subject to additional drug/alcohol screen tests without prior notice. Drug screens will be performed following accidents, unusual behavior, habitual lateness, or for any other classic pattern of drug/alcohol use, and may be observed by a medical professional.

I have read and understand the above conditions of employment and agree to the testing required and to release of test results to the company by the clinic or hospital administering the test.

APPLICANT’S SIGNATURE: __________________________________________________________

PRINT APPLICANT’S NAME: ________________________________________________________

DATE OF APPLICATION: __________________________________________________________

LOCATION OF TERMINAL: __________________________________________________________

Employee: _____________________________________ Facility:Date:

Uniform Sizes

Upon hire, employees will be issued approved uniforms. Where applicable, employees will receive additional seasonal uniforms. If a uniform needs to be repaired or replaced, it should be returned to the Manager, and another uniform will be issued to replace it.

Upon separation of employment, uniforms should be returned at the end of the last day worked.

Please enter your preferred apparel sizes for the following items, as applicable:

T-Shirts:

Polo Shirts:

Button Down Shirts:

Sweatshirt/Hoodie/Sweater:

Jacket:

Pants:

Coveralls:

DISCLOSURE AND AUTHORIZATION TO OBTAIN CONSUMER AND/OR INVESTIGATIVE CONSUMER REPORT

I, the undersigned, hereby consent and authorize INTER-RAIL MANAGEMENT, INC., its affiliated companies, and/or its agents (collectively, herein after referred to as “the Company") to obtain information about me from a consumer reporting agency for employment purposes. I understand that this means that a "consumer report" and/or an "investigative consumer report" may be requested which may include information regarding my character; general reputation; personal characteristics and mode of living, whichever are applicable. The report may also contain information relating to my criminal history, credit history, motor vehicle records such as driving records, social security verification, verification of education or employment history or other background checks. This may involve personal interviews with sources such as neighbors, friends or associates. These reports may be obtained at any time after receipt of my authorization. and if I am hired, throughout my employment. I understand I have the right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report to e-Verifile, 900 Circle 75 Parkway, Suite 1550, Atlanta GA 30339 - 770-859-9899. For information about e- Verifile's privacy practices see www.e-verifile.com. The scope of this notice and authorization is not limited to the present and, if hired, will continue and allow the Company to conduct future screenings for retention, promotion or reassignment unless revoked by me in writing. The Company also reserves the right to share background investigation results with any third-party companies for whom I will be placed to work with as a representative of the Company. My information will only be used and/or disclosed as permitted by law and as required for creation of any report(s).

I HEREBY CERTIFY THAT THIS FORM WAS COMPLETED BY ME, THAT THE INFORMATION PROVIDED IS TRUE AND CORRECT AS OF THE DATE HEREOF AND I AUTHORIZE E-VERIFILE TO OBTAIN A CONSUMER REPORT AND/OR INVESTIGATIVE CONSUMER REPORT ON ME, AS APPLICABLE. I acknowledge that the Company has provided with a copy of A Summary of Your Rights Under the Fair Credit Reporting Act.

Signature: Date:

Please Print:

Name: First Middle Last

Social Security Number:

Date of Birth*:

Gender* (check one): Male Female

Driver's License # Issuing State

Daytime Phone Number __________________

Other Names used (alias, maiden, nickname):

Current Address: _ Street Number and Name City State Zip code Dates

List any other addresses that you have used in the last 7 years:

Street Number and Name City State Zip code Dates

Street Number and Name City State Zip code Dates

Street Number and Name City State Zip code Dates

CA, MN, OK applicants or employees only I understand that if the Company requests a copy of my consumer report for employment purposes, I have the right under California, Minnesota and Oklahoma law to receive a copy of that consumer report from the Company free of charge. I understand that by checking "yes" below, a copy will be provided to me at the address I provide above.

I would like to receive a copy of my consumer report (background check) (CA. MN, OK only) Yes No

* Note: Date of Birth and Gender information are required for identification purposes only, and are in no manner used as qualifying for joining

the Company

900 Circle 75 Parkway • Suite 1550 • Atlanta GA 30339 • 770- 859-9899 • Fax: 770-859-0717

Prefer not to self identify