Warehouse Loader - Hasein Hines (NO-267783)

NO-****** - Warehouse Person (Loader)

Apr **, ***5

Personal Information

Legal First Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hasein Legal Last Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hines Preferred First Name .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Leave Blank if no Preferred First Name

Hasein

Preferred Last Name .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Leave Blank if no Preferred Last Name

Hines

Preferred Pronouns .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . He/Him Email Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *********@*****.*** Phone Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Please enter your 10 digit phone number using this format (XXX) XXX- XXXX; Do not include the leading 1.

838-***-****

Mailing Address

Address 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 James st Apt #2 Address 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Schenectady State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New York Zip/Postal Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12304 Time Zone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . US/Eastern Country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . United States Position: Warehouse Person (Loader)

Location: Albany (Manufacturing), NY

Other Information

Have you previously been employed by PepsiCo Beverages North America or any other PepsiCo subsidiaries? No

What is your highest level of education? .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Less than HS graduate Employment History

Previous Employer 1

Employer Status** Previous Employer

Company Name** Golub corporation

Job Title** Warehouse

Job Duties** Selector

Employment Start Date** 07/13/2021

Employment End Date** 11/19/2021

Reason for Leaving/Employment** Attendance

Previous Employer 2

Employer Status** Previous Employer

Company Name** Ups

Job Title** Warehouse

Job Duties** Load/unloading

Employment Start Date** 11/16/2019

Employment End Date** 04/01/2021

Reason for Leaving/Employment** Laid off

eSignature

Please read carefully before signing

PepsiCo Beverages North America retains the right to verify all information provided by me. In the process of such verification, I fully authorize PepsiCo Beverages North America to contact any person, school, organization, or employer listed to disclose all information necessary to verify information or statements. I release all persons who disclose such information from any liability or damages to me or anyone acting in my name. I waive any written notice of the release of such information that may be required by any state or federal law. Any falsification, misrepresentation, or omission, whenever discovered, shall be considered legitimate and sufficient grounds for dismissal. If hired, my employment with PepsiCo Beverages North America is at-will. This means that I may terminate my employment at any time. Similarly, the company may terminate my employment at any time, with or without cause.

ELECTRONIC SIGNATURE: Please type your full legal name as shown below Hasein Tiquan Hines

E-Signature

I authorize my Electronic Signature Hasein Hines

Accepted

Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(System will autofill) Apr 10, 2025 12:14 pm

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