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Please review the information on the following pages and complete all required fields. You must electronically sign a Disclosure form and Acknowledgment and Authorization form to authorize Hire Image LLC (www.hireimage.com) to conduct a background check. Hire Image uses secure encryption technology to protect your information. In addition, to safeguard you against unauthorized use of your name, your IP address will be recorded and will be stored along with your unique electronic signature. To ensure your information privacy, all encrypted data is transmitted via secure connection.

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