Employment Application

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references listed above to give any and all information concerning my previous employment. All Information provided on this form by the job applicant or employer is provided voluntarily. The Illinois Department of Employment Security (“IDES”) does not investigate or validate this information, nor does IDES assume any legal liability or responsibility as to the accuracy, currency, quality or validity of this information, nor does IDES make any warranties or guarantees, express or implied, with respect to this information, nor does IDES assume any legal liability or responsibility as to the accuracy, currency, quality, or validity of this information. By using this form, job applicants and employers agree to hold IDES and its officers, employees and agents harmless from any cause of action which might arise as a result of the job applicant’s or employer’s use of this form. Job applicants and employers assume the risk of use of, and reliance on information provided through, this form. Neither IDES nor its officers, employees or agents shall be liable under any theory, legal or equitable, for any claims or damages related to a job applicant’s or employer’s use of this form.