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PRE-EMPLOYMENT DECLARATION

In connection with my application for employment, I hereby declare that I have not been
employed with ELITE COLLECTION AND BUSINESS SERVICES INC. or any of its affiliated
companies.

I further declare that the information in this declaration, the information on other documents I
completed during my application and the information I have provided during my interview/s in support with
my application for employment in ELITE COLLECTION AND BUSINESS SERVICES INC. is true and
correct in every detail.

I understand that any incorrect statement in my application or interview on any matter relevant to
my employment with ELITE COLLECTION AND BUSINESS SERVICES INC. may make me liable to
disciplinary actions including termination of employment.

________________________________ ______ ___________________________


Applicant’s Signature over Printed Name Date

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