Application 2009

EMPLOYMENT APPLICATION Please answer all of the questions completely and accurately. Note that upon hire you must agree to sign the Employment Eligibility Verification (Form I-9). As required by the Immigration Reform and Control Act of 1986 and provide supporting documents. Prospective employees will receive consideration without discrimination based on race, color, age, sex, national origin, disability, veteran status or any condition prescribed by federal, state, or local law. I understand that my application is valid only if applying for a job opening and if I am qualified for that job. I may apply for only one position at a time. I may reapply for employment in the future by completing a new application.

Position Applying For:

Date of Application:

Full Time

Requisition Number:

Part Time

PERSONAL INFORMATION Name: (Last)

(First)

(Middle)

Street Address:___________________________ ___________ City:__________________ State: ______________ Zip Code:_________ ___ County: _________________________ Alternate:

Telephone No: Home:

Are you legally authorized to work in the United States?

YES

NO YES

Will you at any time require sponsorship for employment visa status? Are you at least 18 years of age?

YES

NO

NO

Have you previously applied or been employed with PlainsCapital?

YES

NO

If yes: month, year, and location: Are you related to anyone currently employed with PlainsCapital?

YES

NO

If yes: name/s and location: Salary requirements: Have you ever pled guilty or been convicted of a crime or misdemeanor of any type or participated in deferred adjudication or a similar program or received a prior conviction of YES NO any crime? If yes; please provide more specific information. A conviction will not necessarily disqualify you from employment consideration. County:

State:

Disposition of Conviction:

REFERRAL INFORMATION SOURCE (Please list all that apply) _________________________________________________________________________________ Revised June 2009

PlainsCapital Is An AA/EEO D/V/M Employer

EMPLOYMENT APPLICATION

EDUCATION High School

Graduated or GED YES

Name:

NO

City: State: College Name:

Graduate YES

Major Courses

NO

City:

_____________________ _____________________

State:

Graduate School Name:

_____________________

Degree:

Graduate YES

Major Courses

NO

City:

_____________________ _____________________

State:

Other Education Name:

_____________________

Degree:

Graduate YES

Major Courses

NO

City: State:

_____________________ _____________________ _____________________

Degree:

List scholastic honors, honorary organizations, scholarships:

Special Business Skills: Special Computer Skills: Professional Credentials (licenses): Professional Organizations: Revised June 2009

PlainsCapital Is An AA/EEO D/V/M Employer

EMPLOYMENT APPLICATION

EMPLOYMENT HISTORY List current or last employer first, then follow with previous employers. Provide accurate full-time and part-time employment information explaining any gap (s) in employment history. Please be thorough. May we contact your current employer? YES NO Current / Last Employer Name:

Dates Employed:

Work Performed:

Complete Address:

From:

________________________

To:

________________________

Corporate Phone:

________________________

Job Title:

________________________

Supervisor:

Rate of Pay:

Reason for Leaving:

Title:

Start:

________________________

Phone:

End:

________________________

Name:

Dates Employed:

Work Performed:

Complete Address:

From:

________________________

To:

________________________

Previous Employer

Corporate Phone:

________________________

Job Title:

________________________

Supervisor:

Rate of Pay:

Reason for Leaving:

Title:

Start:

________________________

Phone:

End:

________________________

Revised June 2009

PlainsCapital Is An AA/EEO D/V/M Employer

EMPLOYMENT APPLICATION Previous Employer Name:

Dates Employed:

Work Performed:

Complete Address:

From:

________________________

To:

________________________

Corporate Phone:

________________________

Job Title:

________________________

Supervisor:

Rate of Pay:

Reason for Leaving:

Title:

Start:

________________________

Phone:

End:

________________________

Name:

Dates Employed:

Work Performed:

Complete Address:

From:

________________________

To:

________________________

Previous Employer

Corporate Phone:

________________________

Job Title:

________________________

Supervisor:

Rate of Pay:

Reason for Leaving:

Title:

Start:

________________________

Phone:

End:

________________________

Name:

Dates Employed:

Work Performed:

Complete Address:

From:

________________________

To:

________________________

Previous Employer

Corporate Phone:

________________________

Job Title:

________________________

Supervisor:

Rate of Pay:

Reason for Leaving:

Title:

Start:

________________________

Phone:

End:

________________________

Revised June 2009

PlainsCapital Is An AA/EEO D/V/M Employer

EMPLOYMENT APPLICATION

NOTICE TO JOB APPLICANTS PlainsCapital Corporation has the right to verify certain information contained in your application for employment. The information requested below is necessary to complete this task. This information is NOT a part of the application for employment and will be used for the sole purpose of verification of information, and or statements made by you. Please complete all information requested. It is possible that your employment may be determined in whole or in part by PlainsCapital Corporation using data from a report supplied by a background service company. Pursuant to Section 609 of the Fair Credit Reporting Act, you may be entitled to a copy of this report.

Applicant’s Legal Name

Last

First

M.I.

Please provide any other name used for prior employment or school that differentiates from the above.

Last

First

M.I

Date of Birth:

Social Security #

(Month/Day/Year)

Name as it Appears on Driver’s License: Driver’s License #

State:

Residential History: List all residential addresses in the last 7 years Address City State Zip From

Present

Address

City

State

Zip

From

To

Address

City

State

Zip

From

To

APPLICANT CONSENT I understand and agree that PlainsCapital Corporation will verify all or part of the information I have provided. I understand that this verification may include any inquiry into my credit history, motor vehicle driving record, criminal and civil records, prior employment (including contacting prior employers), education (degree, GPA and attendance) as well as other public record information. I authorize the release of such information as may be necessary to verify the information I have provided. I release and hold harmless from all liability any individual or entity requesting or supplying information with respect to my application for employment. I certify that all statements made by me on this application are true and complete to the best of my knowledge, and that I withheld nothing that would, if disclosed, affect this application unfavorably.

do or do not authorize you to contact my current employer for Employment I hereby and Reference Verifications. Applicant Signature: Revised June 2009

Date: PlainsCapital Is An AA/EEO D/V/M Employer

EMPLOYMENT APPLICATION

PERSONAL REFERENCES Give name, address, telephone number and relationship of three references that are not related to you and are not previous employers. 1.

2.

3.

I understand that certain jobs may require a criminal background investigation, and I authorize the company to perform that investigation at Company expense. I understand that the Company may refuse to hire me as a result of that investigation, and I agree to hold the company harmless. I agree that refusal to authorize the background investigation will constitute my voluntary withdrawal from the selection process. I authorize the Company to undertake an investigation of all information contained in this application for employment or resume as presented for consideration for employment. I release from all liability all persons, companies, and corporations supplying such information. The information I have provided in this application for employment is true, correct, and complete. False, incomplete or misrepresented information of any kind will be sufficient cause for my application to be rejected or, if discovered after I am employed, cause for termination of my employment. I also understand that the Company may periodically conduct investigation/credit check during the course of my employment.

a

background

Additionally, I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between the Company and me for either employment or for the providing of any benefit. No promises regarding employment relationship is established, I understand that I have the right to terminate my employment at any time and that the Company retains the same right. I have read and understood the above. Signature of Applicant:

Revised June 2009

Date:

________

PlainsCapital Is An AA/EEO D/V/M Employer

EMPLOYMENT APPLICATION

EMPLOYMENT DATA RECORD Employees are treated during employment without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or disability, or other legally protected status. As an employer with an Affirmative Action Program, we comply with government regulations, including Affirmative Action responsibilities where they apply. The purpose for this data record is to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of this data record is optional. If you choose to volunteer the requested information please note that all data records are kept in a confidential file and are not a part of your Application for Employment or personnel file. Please note: your cooperation is voluntary. Inclusion or exclusion of any data will not affect any employment decision.

VOLUNTARY SURVEY Government agencies at times require periodic reports on the sex, ethnicity, disability, veteran and other protected status of employees. This data is for statistical analysis with respect to the success of the Affirmative Action program. SUBMISSION OF THIS INFORMATION IS VOLUNTARY. Please Print Name: (Last)

(First)

(Middle)

Date:

Current Job: Check One:

Male

Female

Check one of the following: (Ethnic Origin) White

Hispanic

American Indian/Alaskan Native

Black

Other

Asian/Pacific Islander

Check which type of position you are applying for: Clerical

Professional

Official/Manager

Service or Operator

Which of the following is applicable? Served in the U.S. Armed Forces Vietnam Veteran

Revised June 2009

Disabled Veteran

Disabled Individual

PlainsCapital Is An AA/EEO D/V/M Employer