I, the undersigned, affirm that the information given by me on this application is true and correct and I hereby acknowledge that falsification of any part of this application may result in denial exclusion from examination, denial of employment or discharge after employment. I understand that, in addition to testing required by the Board of Fiore and Police Commissioners, that a physical examination and drug screen will be required prior to beginning employment and that I will be required to undergo drug testing if deemed necessary by supervisory personnel. I also understand that upon commencing employment, I will be required to maintain permanent residency in accordance with the Collective Bargaining Agreement then in effect, which currently requires residency within the boundary lines of McDonough, Warren, Henderson, Fulton, Hancock, Knox, or Schuyler County, Illinois.

In connection with my application for employment with the City of Macomb, I understand and agree that investigative inquiries are to be made which may include, but not limited to: my consumer credit, criminal convictions, motor vehicle history, educational transcripts, and other reports of any nature and type, including information in the public domain. These reports will include information as to my character, work, habits, performance, and experience together with reasons for termination of past employment. I hereby agree to release and hold harmless the City of Macomb, its employees (elected or appointed), the Board of Fire and Police Commissioners, and any and all of their agents, from and against any claim or claims arising as a result of the conduct of any background investigation they may determine appropriate and necessary upon and of me to ascertain my fitness for the position sought; or any tests taken or to be taken by me for and to determine my fitness for the position sought; and to generally and specifically waive and agree to hold harmless those persons, firms, corporations, and other entities who supply requested information during the conduct of an investigation of fitness for the position being sought. I understand and agree that the City of Macomb and/or Board of Fire and Police Commissioners may request information from various federal, state, and other agencies that maintain records concerning my past activities related to my driving, credit, criminal, education, and other experiences. I authorize without any reservations all corporations, companies, municipalities, credit agencies, persons, educational institutions, law enforcement agencies, and former employers to release information they may have about me, and release them from any liability and responsibility for doing so. I understand successful completion of physical and psychological examinations are required prior to beginning employment. All test scores are the property of the Commission and are not available to applicants. I hereby acknowledge and understand that I must pass the Physical Fitness Standards required by the Illinois Law Enforcement Training and Standards Board before entering any of the Illinois police academies. I also understand that if hired, I will be required to maintain residency in accordance with the Collective Bargaining Agreement then in effect. I understand that a physical fitness test is required prior to commencement of employment and warrant that I am physically fit and able to take said physical fitness test. I hereby waive any and all liability and release and hold harmless the City of Macomb, its employees (hired, elected or appointed), the Board of Fire and Police Commissioners, and any and all of their agents from any claim or claims arising as a result of my performance of the physical fitness test. This authorization, in original copy, or facsimile form, shall be valid for this and any future reports that may be requested. I hereby authorize investigation of all statements made by me with no liability arising there from.