Machine Operator Safety Compliance

Employee Authorization – Background Verification

I hereby acknowledge that I have been informed that I will be working in a food Production facility that requires the highest level of security and that a full Background check may be carried out.

I have voluntarily provided the information and authorize Palmetto Gourmet Foods and its representatives to complete background verification. Name:

Phone Number:

Address :

Social Security Number:

Birth Date: - -

Email Address:

Employee Signature Date