Employment Application COURTLAND MANAGEMENT CORP Thank you for your interest in working at our company. You are applying for a position at one of the Courtland Management Corp related companies*. We appreciate your application and look forward to the possibility of you joining our team. Please complete the following application. Please print all information so it may be easily read. Be certain all forms are completely filled out and signed. Use the abbreviation "N/A" if a particular provision or section in the form is not applicable to you. Incomplete applications will not be considered. Your application will remain in our active files for a period of sixty (60) days. Should an appropriate opening occur, your application will be reviewed along with others. If you are among the most qualified applicants for a position, an interview will be arranged. Please notify us in writing if your address or telephone number should change. Any applicant wishing to be considered for employment beyond this time period should resubmit an application. Employment decisions are made solely on the basis of qualifications to perform the work for which you are applying. Qualifications include, but are not limited to, education, training and work experience. Credentials and experience will be verified through consumer reports, schools, former employers and licensing/certification agencies, if applicable. We appreciate your cooperation. As an Equal Opportunity Employer, decisions to hire and promote are made without regard to race, color, creed, national origin, sex (including pregnancy), physical or mental disability or age (as defined by law). *Courtland Management Corp is the generic name used, that refers to one of the following related companies: National Pawn Inc., Courtland Financial Corp., Countywide Financial L.L.C., National CSO Loan Corp., EZ Gold Exchange L.L.C., Arizona EZ $ Gold Buyers Inc., Ocho Financial L.L.C., Courtland Management Arizona L.L.C., Courtland Management Oklahoma L.L.C., Courtland Financial Oklahoma L.P., Pima County Financial L.P., Maricopa County Financial L.P. APPLICATION FOR EMPLOYMENT Personal Information First Name*: Last Name*: Date of Application*: Your Email*: Present Address*: City*: State*: Zip*: Phone*: Other Phone*: 1. Have you ever been known by any names other than the one listed above?* YesNo If yes, please list names: 2. Notify in case of Emergency: Name:* Relationship:* Phone:* Address:* 3. If you are under 18 years of age, can you provide required proof of your eligibility to work?* YesNo Proof of citizenship or immigration status WILL be required upon employment 4. Position(s) applying for:* 5. On what date would you be available for work?:* 6. What location are you applying for?1) 110 West University Rd., Austin, TX 786262) 11301 North IH 35, Austin, TX 787533) 1166 Airport Blvd., TX, 787024) 111 W. William Cannon, Austin, TX 787455) 1711 South IH 35, San Marcos, TX 786666) 419 Saint George St., Gonzales, TX 786297) 5405 S. Pleasant Valley, Austin, TX 787448) 1350 Palm Valley Blvd., Round Rock, TX 786649) 5416 Manchaca Rd., Austin, TX 7874510) 2201 Lake Austin Blvd., Austin, TX 7870311) 1500 W. Cameron Rd., Rockdale, TX 7656712) 422 North Oak St., Pearsall, TX 7806113) 2121 W. Parmer Ln. Suite 109B, Austin, TX 7872714) 9204 Highway 290, Austin, TX 7873621) 2710 Bethany Home Rd., Phoenix, AZ 8501723) 2619 West Glendale Suite 1A, Phoenix, AZ 8505124) 7530 West Peoria, Peoria, AZ 8534525) 6413 East Thomas Rd., Scottsdale, AZ 8525126) 2848 East Bell Rd., Phoenix, AZ 8503227) 8943 North 43rd Ave., Phoenix, AZ 8505128) 2050 W. Guadalupe Rd., Mesa, AZ 8520229) 25 West Baseline, Phoenix, AZ 8503230) 15231 N. 87th Suite 125, Scottsdale, AZ 8503241) 3030 South 6th Ave., Tucson, AZ 8571342) 4202 East 22nd St., Tucson, AZ 8507443) 903 West Irvington, Tucson, AZ 8507444) 7075 East 22nd St, Tucson, AZ 8571045) 2880 East Grant Rd., Tucson, AZ 8751652) 901 East Cesar Chavez St., Austin, TX 7870261) 3130 South Sheridan, Tulsa, OK 7414571) 3701 South Blvd., Charlotte, NC 2821772) 3101 South Blvd., Charlotte, NC 2820973) 7025 South Blvd., Charlotte, NC 2821774) 799 West Charlotte Ave., NC 28120Other) 7. Are you able to work:* Full-timePart-timeShift-WorkTemp 8. Can you travel if a job requires it?* YesNo 9. Do you have a valid Drivers License?* YesNo 10. Do you have or have access to reliable transportation?* YesNo 11. Have you ever filed an application with us before?* YesNo If yes, Date 12. Have you ever been employed with us before?* YesNo If yes, Date 13. Have you ever been arrested/charged and/or convicted of a misdemeanor or felony other than a minor motor vehicle violation?*YesNo If yes, please explain 14. Are you currently under indictment in any county, in any state, or part of any criminal proceedings or charged with a crime by information?*YesNo If yes, please explain 15. Are you literate in English?* YesNo 16. Are you literate in Spanish?* YesNo 17. EDUCATION Name & Location Year Completed Did you Graduate? Subject/Degree Studied 01234 NoYes 012345+ NoYes 012345+ NoYes 18. State any additional information you feel may be helpful to us in considering your application:* 19. Are you a U.S. Veteran? YesNo Date of service: Nature of Duty or Training of service: PROFESSIONAL LICENSES and/or CERTIFICATIONS Type/Number Organization/State Issued Date Issued 20. Have you ever had an application for any type of professional or occupational license disapproved or any such license suspended, canceled or revoked?* YesNo EMPLOYMENT RECORD 21. Are you currently employed?* YesNo 22. We routinely contact an applicant's current employer for reference checks. Would this pose any particular difficulty for you?* YesNo If yes, please explain List previous employment information: 23. Current or Last Employer*: Date of Employment*: Salary*: Address*: Phone*: Supervisor*: Position and Duties*: Reason for Leaving*: Date of Departure*: Is there a "Gap" period of time between employement?* YesNo If Yes, please explain*: UnemployedillSchoolOther Explain other*: 24. Next Previous Employer*: Date of Employment*: Salary*: Address*: Phone*: Supervisor*: Position and Duties*: Reason for Leaving*: Date of Departure*: Is there a "Gap" period of time between employement?* YesNo If Yes, please explain*: UnemployedillSchoolOther Explain other*: 25. Next Previous Employer*: Date of Employment*: Salary*: Address*: Phone*: Supervisor*: Position and Duties*: Reason for Leaving*: Date of Departure*: Is there a "Gap" period of time between employement?* YesNo If Yes, please explain*: UnemployedillSchoolOther Explain other: 26. Next Previous Employer*: Date of Employment*: Salary*: Address*: Phone*: Supervisor*: Position and Duties*: Reason for Leaving*: Date of Departure*: Is there a "Gap" period of time between employement?* YesNo If Yes, please explain*: UnemployedillSchoolOther Explain other: 27. Next Previous Employer*: Date of Employment*: Salary*: Address*: Phone*: Supervisor*: Position and Duties*: Reason for Leaving*: Date of Departure*: Is there a "Gap" period of time between employement?* YesNo If Yes, please explain*: UnemployedillSchoolOther Explain other: 28. Have you ever been terminated from employment for any reason or requested to resign from any position?* YesNo If yes, please explain 29. Use this space to give us other information about special job-related skills and qualifications acquired from employment or other experience:* 30. Personal References (3 are Required. Do not include persons who are related to you or are previous employers. ) Name Address Phone Occupation Years Known 31. Professional References (3 are Required. Do not include persons who are related to you.) Name Address Phone Occupation Years Known I certify that all information given on this application is true, correct and complete to the best of my knowledge. I also certify that I have accounted for all of my work experience, training and arrest/conviction records on this application, and that I have not knowingly withheld any fact or circumstance which would, if disclosed, affect my application unfavorably. Courtland Management Corp is hereby authorized to make any investigation of my personal history including, academic credentials, military service records, arrest, criminal, driving, financial and credit record through any investigative consumer reporting agencies or bureaus of its choice. I release all parties named herein from all liability of any damages resulting from furnishing such information. In making this application for employment, I authorize you to make an investigative interview report whereby information is obtained through personal interviews with my neighbors, friends or others with whom I am acquainted. This inquiry, if made, may include information as to my character and general reputation. I authorize any inquiry to be made on any information contained in this application if I am considered for employment. I agree to furnish additional information as may be required to complete my employment file. I understand that discovery of misrepresentation or omission of facts herein will be cause for immediate dismissal. Further, until I have been employed at least (90) days, I will not receive full company benefits. I understand and acknowledge that 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. I agree to abide by its rules and regulations. I understand that operating conditions may require me to temporarily work shifts other than the one for which I am applying and I agree to such scheduling change as directed by my supervisor. If applicable, I understand that I am responsible for obtaining any and all employee licenses required to do the job I have applied for. Should any license, personal or employment history check, arrest/conviction record check or other information required by state or local rule or regulation necessary to maintain my employment disqualify me, I hereby acknowledge that I understand and expressly agree that the company may discharge me immediately and that I have no recourse against the company for action. I further understand that I may be required to submit to a drug screen and that my continued employment is conditioned on the results of such screen. If I am terminated for failure to pass such required drug screen, I understand I have no recourse against the company for such action. I understand that my employment will require certain physical capabilities relating to the ability to lift, push, pull and transport objects weighing up to 80 lbs., assist other employees in physical tasks and to stand for most of my shift, either on a regular basis or from time to time. I must be physically capable of performing these activities as needed to complete my duties. My employment also requires that I am alert at all times to potential safety hazards or dangerous situations. I am required to remain vigilant to unsafe conditions. I must report all hazardous conditions to my supervisor and, if possible, I should correct the situation myself so as to render it safe. I further understand that this is an application for employment and that no employment contract is being offered; and understand that if employed, such employment is for an indefinite period and can be terminated at will by either party, with or without notice, at any time, for any or no reason, and is subject to change in wages, conditions, benefits and operating policies. Date:* Signature:* This application is the property of Courtland Management Corp.