I hereby certify that the informati

I hereby certify that the information I supplied in this application is true, complete, and correct to the best of my knowledge, and I understand that any information I withheld or falsely provided in connection with the foregoing application shall be cause for rejection of this application or termination of employment. Prior to extension of any offer of employment, I hereby authorize Halliburton Energy Services Inc. or its designee, without liability, to contact prior employers (present employer if authorized), schools or references I have given and authorize said employers, schools, or references, to make full response to any inquiry by Halliburton Energy Services Inc. or its designee in connection with this application for employment. I authorize, without reservation, any party or agency contacted by Halliburton Energy Services Inc. or its designees to furnish the information mentioned above. I understand the information obtained will be used as one basis for employment or denial of employment. I hereby discharge, release and indemnify the prospective employer, Halliburton Energy Services Inc., their agents, servants and employees, and all parties that rely on this release and/or the information obtained with this release from any and all liability and claims arising by reason of the use of this release and dissemination of information that is false and untrue if obtained from a third party without verification