*************************ATTENTION APPLICANT********************

Your identity was not able to be verified online, to complete your background screening,
please visit one of Uber Greenlight Hubs. For more information on where to go and what
document to bring,

https://www.uber.com/en-CA/drive/resources/ontario-background-screening/

If you have any questions regarding this request please contact our customer service
department at: 1-866-542-0999.

Yours Truly,

Triton Canada Inc.

Customer Service

customerservice@tritoncanada.ca
 CRIMINAL RECORD CHECK (CRC)
Informed Consent Form
12705315
A. Personal Information
Surname (last name): Sandhi Given names(s): Mohammadadnan Jakir
Surname (last name) at birth: Former name(s):
Place of birth (City, Province/State, Country): Vadodara, India
Date of birth (YYYY-MM-DD): 2002-02-01 Sex: ☐ Female ☐
✘ Male

Phone number(s): 4374417524 Email address: adnansandhi009@gmail.com

Current Home Address
4
________ Jamadar faliyu, mesrad
_________________________________________________ __________ Vadodara
___________________ Gujrat
____________________ 392220
______________
Number Street Apartment City Province/Territory/State Postal/ZIP code

Previous Address(es) Within the Last 5 Years (attach additional page if necessary)
________ _______________________________________________ __________ ___________________ ____________________ ______________

________ _______________________________________________ __________ ___________________ ____________________ ______________

B. Reason for the Criminal Record Check (CRC)

Reason for Request (example: Employment – Employer – Job Title): Independent Driver
Organization Requesting Search: Uber API - ON
Contact Name: UBER Canada Contact Phone Number:
C. Informed Consent

SEARCH AUTHORIZATION – I HEREBY CONSENT TO THE SEARCH OF the RCMP National Repository of Criminal Records based on the name(s), date of birth and where used,
the declared criminal record history provided by myself. I understand that this verification of the National Repository of Criminal Records is not being confirmed by
fingerprint comparison which is the only true means by which to confirm if a criminal record exists in the National Repository of Criminal Records.

POLICE INFORMATION SYSTEM(S) – I HEREBY CONSENT TO THE SEARCH OF police information systems, as part of a Criminal Record and Judicial Matters Check, which will
consist of a search of the following systems (check applicable):
☐
✘ CPIC investigative Data Bank ☐
✘ Police Information Portal (PIP)

AUTHORIZATION AND WAIVER to provide a confirmation of criminal record or any police information.

I certify that the information set out by me in this application is true and correct to the best of my ability. I consent to the release of the results of the criminal record checks
Triton Canada Inc
to ________________________ Toronto, Canada
, located in ________________________________
Company Name City and Country

I hereby release and forever discharge all members and employees of the processing Police Service and the Royal Canadian Mounted Police from any and all actions, claims
and demands for damages, loss or injury howsoever arising which may hereafter be sustained by myself as a result of the disclosure of information by the
Brockville/Cobourg/OwenSound/NewWestminster/West Vancouver/Treaty
____________________________________________________ Triton
Three/Annapolis
Canada Inc and/or
Royal/itsTsuutina
agents Nation Police Service
to __________________________________________________ Toronto, Canada
, ____________________________.
Name of Processing Police Service Company Name City and Country

Signature of Applicant Date Signed at

Year – Month - Day Gujrat
Vadodara
2024/01/31 City Province/Territory

D. Identification Verification ☐ Physical Identity Verification ☐ Electronic Identity Verification

Witnessing Agent’s Name: Identification Verified: Yes No

Type of Photo ID Viewed

Witnessing Agent’s Signature:
(Government Issued) & Secondary ID

Triton Canada Inc. - Toronto, Ontario

Name and location of the company where information will be stored in Canada: ____________________________________________________________________________.

**Information related to this criminal record check is collected, retained and disclosed in accordance with applicable privacy legislation. **
 Criminal Background/Public Safety/Credit Check Form/Drivers Abstract
Important – to be completed by employer or recruiter
1. Photocopy 2 pieces of identification, 1 piece must be government issued with candidates’s picture and signature.
2. Scan these pages and upload them into your account on the Triton Canada Inc Website at www.tritoncanada.ca or Email to submit@tritoncanada.ca or Fax to
1-866-284-3149.
3. When photocopying ID, ensure it is clear and can be read.
12705315

Services Ordered: Criminal Background Check ✔ Credit Bureau Inquiry Drivers Abstract Public Safety

Identification Verification of employee by employer or recruiter

Uber API - ON
_________________________ 16b0d9ee-7d18-4a60-82a2-c028c5910876
__________________________ ubersupport@tritoncanada.ca
____________________________
Company Client Code/Name/Location Manager’s Email Address

I have examined the identification of the person below and am satisfied that the person depicted on the photo identification is one and the same.

UBER
__________________________ Canada
__________________________ X______________________________________
Manager’s First Name Last Name Verifier/Manager Signature

2 Have you ever been convicted of a criminal offence? Yes No ✔

If “Yes” please provide details below. Do not declare the following: Absolute discharges or Conditional Discharges, pursuant to the Criminal Code,
section 730. Any charges for which you have received a Pardon, pursuant to the Criminal Records Act. Any offences while you were a “young person” (12 years old but less
than 18 years old), pursuant to the Youth Criminal Justice Act. Any charges for which you were not convicted, for example, charges that were withdrawn, dismissed, etc. Any
provincial or municipal offences. Any charges dealt with outside of Canada.
Offence Year Location Penalty

More declarations on next page? Yes No

✔
3
Candidate Consent

Mohammadadnan
_____________________________ Jakir
_________________________ Sandhi
_______________________
First Name Middle Name Last Name

_____________________________ 2 1
Birth Date ________ _____ __________ 2002 Gender Male ✔ Female
Maiden Name(s) / Alias (Other Names) Month Day Year

4 Jamadar faliyu, mesrad, Vadodara, Gujrat, India, 392220

___________________________________________________ 4374417524
_____________________________
Present Address (street name, number, city, province, postal code) Telephone

____________________________________________________________________ Vadodara, India

__________________________________
Previous Address (if present address is less than 5 years) Place of Birth (Town, Prov., Country or Hospital)

____________________________________________ adnansandhi009@gmail.com
__________________________________
Drivers License # Email Address
I have applied to Uber for Independent Driver. Part of the screening process includes a criminal history check which searches the RCMP Canadian Police Information Centre (CPIC) database. Triton
Canada Inc and/or its agents conducts these investigations on behalf of Uber. I hereby consent and authorize a Canadian Police Department to search for and disclose on my behalf to Triton Canada
Inc and/or its agents who is requesting the criminal history check on behalf of Uber the fact that records may exist on me and are registered on the CPIC database. I acknowledge that such records may
include information relating to criminal convictions under federal legislation for which a pardon has not been granted. I authorize Triton Canada Inc and/or its agents to release all information obtained to
Uber and hold harmless Triton Canada Inc and/or its agents upon the release of this information or its findings to Uber. The Applicant consents to the release of the information contained in the
application and results of the criminal reference check being disclosed to the necessary third party for the purposes of Uber business. I understand that failing to provide accurate information or omission
of facts herein may disqualify me from consideration for Independent Driver with Uber. Furthermore, if there is a discrepancy with the information provided by myself on this form and that disclosed by a
Canadian Police Department during this investigation of my criminal records history, I understand that I have the option to provide my fingerprints to resolve any discrepancy or dispute. This request is
made in compliance with any applicable federal, provincial or municipal public sector privacy legislation which allows a public body or municipality to disclose my personal information to me or my agent
upon my request.

X___________________________________________________ 2024/01/31
_______________________________________
Individual’s Signature Authorizing Name Based Criminal Check Date
In connection with my application to become a driver partner with Uber, I understand that background check process includes a Driver’s Abstract inquiry . I hereby consent to a Driver’s Abstract be
requested on my behalf by Triton Canada. I hereby authorize any public or private institution to provide and release to Triton information related to my Driver’s Abstract. I authorize Triton to release all
personal information obtained to Uber and hold harmless TRITON upon the release of this information or its findings to Uber.

X____________________________________________________________ ______________________________________________
Individual’s Signature Authorizing Credit Bureau Inquiry Date
Revision: November 2012