Accountants One Data Sheet Electronic Signature Agreement

We are pleased to offer you an on-line option to collect your skills. This information is important for us to assist you and will be held in strict confidence.

By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions

I Accept that I am signing this Agreement electronically

THE FOLLOWING FORM IS USED BY OUR COUNSELORS TO ASSIST YOU IN YOUR EMPLOYMENT GOALS.WE APPRECIATE YOUR COOPERATION IN COMPLETING THIS FORM. PLEASE PRINT CLEARLY.

POSITION________________________

INTERVIEWED BY_________________

DATE____________________________

PERMANENT AND CONTRACT PLACEMENT

SALARY EXPECTED

LEAST ACCEPTABLE

LAST NAME FIRST MIDDLE SOCIAL SECURITY NUMBER

ADDRESS CITY STATE ZIP

POSITION I AM BEST SUITED FOR WORK PHONE__________________________________________________ HOME PHONE__________________________________________________ CELLULAR_____________________________________________________

DESIRED INTERVIEWING TIMES PAGER________________________________________________________ EMERGENCY___________________________________________________ WORK E-MAIL__________________________________________________

HOME E-MAIL__________________________________________________ ARE YOU A SMOKER? ARE YOU ELIGIBLE TO WORK IN THE U.S.? � NO � NO OTHER________________________________________________________ � YES � YES

EMPLOYMENT HISTORY DATES COMPANY NAME INDUSTRY POSITION REASON FOR LEAVING SALARY

(MONTH/YEAR) NAME & COMPLETE ADDRESS (BASE & BONUS)FROM START

TO END

FROM START

TO END

FROM START

TO END

EDUCATION REMARKS (OFFICE USE ONLY)COLLEGE / UNIVERSITY NAME # OF YEARS GPA MAJOR

ADVANCED DEGREEINSTITUTION NAME # OF YEARS GPA MAJOR

� CPA YEAR STATE CERTIFICATION # VERIFIED BY DATE

HOW DID YOU HEAR ABOUT ACCOUNTANTS ONE? DATE AVAILABLE AVAILABLE FOR: (aall that apply) (aall that apply)

� YELLOW PAGES � JOB FAIR � DIRECT HIRE� NEWSPAPER � INTERNET � CONTRACT � PROF. ORGANIZATION � TEMP-TO-HIRE � PART TIME � REFERRAL ______________________________

� OTHER _________________________________

BUSINESS EXPERIENCE COMPUTER EXPERIENCE(aall that apply) (aall that apply)

� ACCOUNTING SERVICE � HOSPITALITY � ACCESS � PLATINUM

� ADVERTISING � IPO � ACCPAC � POWERPOINT

� AEROSPACE � IMPORT/EXPORT � ADP � PROJECT (R/E SOFTWARE)

� AIRLINES � INSURANCE � AMIPRO � QUATTRO-PRO

� ARCHITECTURAL FIRM � LAW FIRM � BEST � QUICKBOOKS

� ASSET BASED LENDING � LEASING � CERIDIAN � REALWORLD

� AUTO � MANUFACTURING � COMPUTER ASSOCIATES � SAP

� BANKING � MEDIA � DBASE � SAS

� COLLECTIONS � MERGERS / ACQUISITION � D & B � SBT

� COMPUTER HARDWARE � MINING � EXCEL � SKYLINE

� COMPUTER SOFTWARE � MORTGAGE � FAS � SOFTWARE 2000

� CONSTRUCTION � NEWSPAPER � FOCUS � SOLOMON

� CONSULTING � NONPROFIT � FOXPRO � SQL

� CPA FIRM � PETROLEUM � GREAT PLAINS � TENMAN

� CREDIT CARD � PHARMACEUTICAL � GRAPHICS PACKAGES � TIMBERLINE

� DISTRIBUTOR � PRINTING � HYPERION � VISUAL BASIC

� EDUCATION � PROPERTY MGMT � IBM/MAC - AS/400 � WINDOWS

� ELECTRONICS � PUBLISHING � JD EDWARDS � WORD

� ENGINEERING � REAL ESTATE - commercial � LOTUS � OTHER _________________

� ENTERTAINMENT � REAL ESTATE - residential � MACROS (any) ______________________________ � ENVIRONMENTAL � RESTAURANT � MAINFRAME __________________________

� FINANCIAL CONSULTING � RETAIL � MAS 90 __________________________

� FOOD & BEVERAGE � SECURITIES � MACINTOSH __________________________

� FREIGHT � SERVICE PROVIDER � M&D, MILLENNIUM, MSA __________________________

� GOVERNMENT � TELECOMMUNICATIONS � NOVELL __________________________

� GOVERNMENT CONTRACTING � TRANSPORTATION � ORACLE __________________________

� HEALTHCARE � TRAVEL � PARADOX __________________________

� HI TECH � UTILITIES � PEACHTREE __________________________

� HOLDING COMPANY � WHOLESALE � PEOPLESOFT __________________________

POSITIONS DESIRED (aall that apply)

� ACCOUNTING MANAGER � DATA ENTRY CLERK � SYSTEMS ANALYST

� A/P CLERK � ENTRY LEVEL � TAX ACCOUNTANT

� A/P MANAGER � FULL CHARGE BKKP � TREASURER � A/P SUPERVISOR � FINANCIAL ANALYST � VP FINANCE

� A/R CLERK � FINANCE MANAGER

� A/R MANAGER � FINANCIAL PLANNER

� A/R SUPERVISOR � FIXED ASSET ACCT

� ASSISTANT CONTROLLER � G/L CLERK TRAVEL PREFERRED LOCATION PREFERRED � BANK RECS � INTERNAL AUDITOR (aall that apply) (aall that apply)� BANKRUPTCY ACCOUNTANT � INVESTMENT BANKER � NONE � NORTH

� BENEFITS MANAGER � INVENTORY/COST CLERK � UP TO 20% � SOUTH

� BILLING CLERK � INVENTORY MANAGER � UP TO 40% � EAST

� BOOKKEEPER � JUNIOR ACCOUNTANT � UP TO 50% � WEST

� CASH MANAGER � OFFICE MANAGER � OVER 50% � DOWNTOWN / MIDTOWN

� CFO � OPERATIONS MANAGER � OTHER __________

� CLERK � PAYROLL MANAGER � WILL RELOCATE

� COLLECTIONS CLERK � PAYROLL SUPERVISOR

� COLLECTIONS MANAGER � PAYROLL CLERK LANGUAGE� COMMERCIAL LENDING MANAGER � PROJECT MANAGER (aall that apply) � CONTROLLER � PROP TAX ACCOUNTANT � CHINESE � FRENCH � GERMAN

� COST ACCOUNTANT � SALES/USE TAX ACCT � INDONESIAN � ITALIAN � JAPANESE

� COST MANAGER � SOFTWARE SPECIALIST � KOREAN � RUSSIAN � SPANISH

� CPA AUDITOR � SENIOR ACCOUNTANT � SWEDISH � TURKISH � OTHER _____________

� CUSTOMER SERVICE � STAFF ACCOUNTANT

JOB SKILLS (aall that apply)

ACCOUNTS PAYABLE COST ACCOUNTING GENERAL LEDGER PUBLIC ACCOUNTING� A/P (review) � COST ACCTG (any) � GENERAL LEDGER (any) � AUDIT

� PROCESSING � ACTIVITY BASED COST � ACCOUNT RECS/ANALYSIS � BANKRUPTCY ACCOUNTS RECEIVABLES � CONSTRUCTION � BANK RECS � CONSULTING SERVICES

� A/R (review) � INVENTORY � COMPUTER CONVERSIONS � FINANCING

� BILLING � JOB ORDER � CONSOLIDATIONS � PUBLIC OFFERINGS/IPO

� CASH APPLICATION � MRP � YEAR END CLOSE-OUT � SEC REPORTING

� COLLECTIONS � PROCESS � FINANCIAL STATEMENTS � TAX

� CREDIT ANALYSIS � PURCHASING � FIXED ASSETS � WRITE-UP

� MEDICARE/MEDICAID � STANDARD � GOVERNMENT CONTRACTING TAXESAUDITING FINANCIAL ANALYSIS � INTERNAL FINANCIAL REPORTING � TAXES (any)

� AUDIT (internal/external) � FINANCIAL ANALYSIS (any) � INTERNATIONAL � FEDERAL

� EDP SYSTEM � ASSET MANAGEMENT � JOINT VENTURE � INTERNATIONAL

� FINANCIAL � DUE DILIGENCE � JOURNAL ENTRIES � PERS FINANCIAL PLANNING

� OPERATIONAL � ECONOMIC VALUE ADDED ANALYSIS � MONTHLY CLOSE-OUT � PROPERTY

CLERICAL � FORECASTING � PORTFOLIO ACCT � SALES & USE

� CUSTOMER SERVICE � MERGER/ACQUISITION � SEC REPORTING � STATE (LOCAL)

� DATA ENTRY � MODELING � STAT REPORTING TREASURY� TYPING � PRICING � SYSTEM LIAISON � TREASURY (any)

CONSULTING � PROJECT MANAGEMENT PAYROLL � BANK NEGOTIATION � CONSULTING (any) � PROCESSING � CASH MANAGEMENT

� LITIGATION � EMPLOYEE BENEFITS � COMMERCIAL LENDING

� MANAGEMENT � MULTI-STATE � CURRENCY TRANSACTIONS

� SYSTEMS � PAYROLL TAX FILINGS � LETTER OF CREDIT � VALUATION � W-2 END OF YEAR � OTHER _______________

SUPERVISED - No. of People HAVE YOU BEEN CONVICTED OF A FELONY WITHIN THE LAST 10 YEARS THAT HAS NOT (aall that apply) EXPUNGED OR BEEN SEALED BY A COURT? � NO � YES (Conviction will not necessarily disqualify applicant from employment.) � 1 - 2 MAY WE CONTACT YOUR CURRENT EMPLOYER? � NO � YES � 3 - 5

� 6 - 9 SO THAT WE MAY VERIFY THE INFORMATION YOU HAVE PROVIDED, PLEASE SUPPLY � 10 + THE FOLLOWING INFORMATION.

REFERENCES - Please complete entirely

BUSINESS NAME COMPANY PHONE TITLE

MAY WE CONTACT?

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BUSINESS NAME COMPANY PHONE TITLE

MAY WE CONTACT?

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BUSINESS NAME COMPANY PHONE TITLE

MAY WE CONTACT?

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PERSONAL NAME COMPANY PHONE TITLE

MAY WE CONTACT?

WORK -

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I request the services of ACCOUNTANTS ONE, INC., (hereinafter called the Agency) to assist me in seeking employ-ment. The professional services the Agency may render me are subject to the provisions of this agreement, as follows:

1. I agree to notify the Agency within one business day of the results of all interviews whether or not resulting inmy acceptance of a position.

2. I understand that I am under no obligation to accept either an interview or a job offer obtained through theAgency’s services, AND THAT NO PLACEMENT FEE OR CHARGE OF ANY KIND IS TO BE PAID BY ME.

3. I will keep the Agency informed of my address and phone number at all times while my application is active,and will inform the Agency promptly if I am no longer seeking employment.

4. I agree that during the one (1) year term of this agreement, and for a period of one (1) year after the termina- tion of this agreement, I will not directly, or indirectly, disclose to any person, firm, company, corporation, or

other entity that is in the business of providing personnel services, recruiting or placement services, or tempo- rary labor, within a fifty (50) mile radius of the Agency’s office, the names, addresses, or any other informa- tion kept confidential by the Agency regarding the customers, former customers, employees, referral sources,

contractors, candidates, or suppliers of the Agency, or divulge any other trade secrets, concerning the Agency’s method of conducting business, the Agency’s pricing or wages, or any other information pertaining to the business of the Agency that I acquire while working with, or being a candidate for the Agency.

5. I will notify the Agency within one business day (1) after the acceptance of any position secured through theAgency or (2) if my employment on such a position is terminated for any reason.

6. I certify that all information provided about my experience is true and authorize verification as required.

7. I acknowledge that Accountants One, Inc. does not discriminate against applicants, candidates, or employeeson the basis or their race, creed, color, religion, national origin, age, sex, disability, or veteran status, and pro-

vides equal opportunities to all applicants, candidates and employees.

8. By my signature herein below, I consent and agree that the Agency may seek information from others in con- nection with my employment applications and career opportunities, which may include obtaining records and

information regarding my prior job experience and performance, character and reputation, education, driving record, criminal background, civil litigation history. I understand that I have the right to request that the Agency disclose to me the nature and the substance of any such information gathered about me. By my sig-

nature herein below, I also consent and agree that such background information about me may be provided to all prospective employers, and that I hereby release the Agency, its employees and its agents , as well as any parties who furnish such background information to the Agency, from any and all liability relating to the obtaining and providing of such background information.

9. I agree that any employment (whether designated as temporary or full time) that I may obtain with theAgency or with any of the Agency’s customers will be ‘employment at will’ and that such employment may beterminated by me or by the employer at any time for any reason.

10. I agree that the terms and conditions of this agreement with the Agency, and any employment obtainedthrough the Agency shall also be governed by the Agency’s Employee Handbook and the Agency’s policiesand procedures, and I agree to abide by all such rules, policies and procedures.

11. I, the undersigned have read and understand the above, and accept this as a binding agreement for theperiod of one year from the date of application. Furthermore, by signing this form I am not limiting myself toan exclusive relationship with Accountants One.

Date_________________________ Sign Here_________________________________

Revision 2.0 5-2020