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Employment Application Package 1-17-11

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Revised 03/15/09 EMPLOYMENT APPLICATION REFERENCE SHEET Thank you for expressing an interest in pursuing a career with Citi. As part of our interview process, we require that you complete an Employment Application. The information you provide on the Employment Application will be used for pre-employment verifications. Therefore, it is very important to complete the application in its entirety, and that your responses are legible and accurate. Missing or inaccurate information could result in delay or denial of employment. To assist in your preparation, indicated below is key information you will need to pay particular attention to as you complete the employment application. Personal Information: Full contact information including your address, zip code, a phone number where you can be reached, and an email address if applicable Eligibility to Work in the United States Criminal Background Information – be sure to answer ALL questions in this section. Positive responses are not an automatic bar to being employed by Citi, but should be explained in detail on the application. Employment Information: Indicate your employment history for the last ten years (or last 5 employers) and whether we can contact your present employer – only your last 5 employers should be provided Company names, addresses, and phone numbers For all contract/ temporary assignments, list the contracting agency as your employer Dates of employment including month and year – accuracy of this information is imperative Reasons for leaving Names of all managers/ supervisors Salary and other compensation Education: Names of all accredited Schools/ Colleges attended (include city and state) Any degrees, diplomas and/ or certificates received, along with major Graduation Dates(s) (for college or other secondary school) List all dates attended in month/year format Tips to Remember: List most recent experiences first. Complete all requested information on all pages. Don't leave anything blank. Do not indicate, “see resume” anywhere on the application, but you may attach a copy of your resume Please avoid acronyms Print clearly and neatly - use black or blue ink only Don't forget to sign and date your application Print single-sided pages only
Transcript
Page 1: Employment Application Package 1-17-11

Revised 03/15/09

EMPLOYMENT APPLICATION REFERENCE SHEET Thank you for expressing an interest in pursuing a career with Citi. As part of our interview process, we require that you complete an Employment Application. The information you provide on the Employment Application will be used for pre-employment verifications. Therefore, it is very important to complete the application in its entirety, and that your responses are legible and accurate. Missing or inaccurate information could result in delay or denial of employment. To assist in your preparation, indicated below is key information you will need to pay particular attention to as you complete the employment application. Personal Information: Full contact information including your address, zip code, a phone number where you can be reached, and an

email address if applicable Eligibility to Work in the United States Criminal Background Information – be sure to answer ALL questions in this section. Positive responses are not

an automatic bar to being employed by Citi, but should be explained in detail on the application. Employment Information: Indicate your employment history for the last ten years (or last 5 employers) and whether we can contact your

present employer – only your last 5 employers should be provided Company names, addresses, and phone numbers For all contract/ temporary assignments, list the contracting agency as your employer Dates of employment including month and year – accuracy of this information is imperative Reasons for leaving Names of all managers/ supervisors Salary and other compensation

Education: Names of all accredited Schools/ Colleges attended (include city and state) Any degrees, diplomas and/ or certificates received, along with major Graduation Dates(s) (for college or other secondary school) List all dates attended in month/year format

TTiippss ttoo RReemmeemmbbeerr:: List most recent experiences first. Complete all requested information on all pages. Don't leave anything blank. Do not indicate, “see resume” anywhere on the application, but you may attach a copy of your resume Please avoid acronyms Print clearly and neatly - use black or blue ink only Don't forget to sign and date your application Print single-sided pages only

Page 2: Employment Application Package 1-17-11

GENERAL INFORMATIONLast Name/Surname Second Last Name

Legal First Name Preferred First Name Middle Name

Current Mailing Address Street Apt. Bldg.

City State/Province/Region ZIP/Postal Code Country

Permanent Address (if different from above)

City State/Province/Region ZIP/Postal Code Country

Telephone number where you prefer to be reached(including country/area code)

( )

Alternate Telephone Number (including country/area code)

( )

Email Address

Previous address(es), if any, for the past 7 years

POSITION APPLYING FORWhat position are you applying for?

Job Title: Citi business unit (if known):

Full-time Part-time

Location: Desired salary: Date available to start:

Source of referral: Advertisement _______________________________ Employee Referral (Name) _________________________________

Agency/Search Firm (Name)______________________ Internet (Website Name) ___________________________________

Job Fair/Open House __________________________ Campus Recruiting ______________________________________

Other _____________________________________________________________________________________________

EMPLOYMENT ELIGIbILITY

Are you legally authorized to work in the United States? Yes NoCan you, within the time period prescribed by law, submit verification of both your identity and authorization to work in the United States? (Proof will be required)

Yes NoWill you, now or in the future, require sponsorship for employment in the United States? Yes NoAre you subject to any order prohibiting you from working at a financial institution? Yes NoIf you are a minor, do you have the necessary work permit or other statutorily required documentation which would permit you to work?

Yes No N/A New York applicants under the age of 25 years will be required to produce proof of age at the time of hire.

Citi is an equal opportunity employer. All applications will receive consideration for employment without regard to race, color, religion, creed, sex, age, national origin, ancestry, marital status (including civil unions as defined and recognized by state law), citizenship status, disability, sexual orientation, veteran status, gender identity or expression, genetic information, or any other legally protected categories. No question on this application is intended to secure information about these subjects.

725745 3022 (11/2010) Page 1 of 7

CITI EMPLOYMENT APPLICATIONAs used herein, “Citi” shall refer to Citigroup Inc., its subsidiaries, and its and their affiliates.

Page 3: Employment Application Package 1-17-11

725745 3022 (11/2010) Page 2 of 7 EMPLOYMENT APPLICATION CONT’D HUMAN RESOURCES

Have you ever been employed by Citi or any of its predecessor companies (including but not limited to Citibank, Citicorp, Salomon Brothers, or Smith Barney)?

Yes No If Yes, Name of Citi business unit: _______________________________ Location: _____________________

Dates: From _____________ to ____________

Have you ever performed services as a consultant or temporary worker for Citi or any of its predecessor companies?

Yes No If Yes, Name of Citi business unit: _________________________________ Location: ____________________

Dates: From _____________ to ____________

Have you ever been involuntarily terminated or asked to resign by Citi or any of its predecessor companies?

Yes No If Yes, Date:______________ Name of Citi business unit: ___________________________________________

Have you ever been denied employment after receiving an offer from Citi or any of its predecessor companies?

Yes No If Yes, Date:______________ Name of Citi business unit: ___________________________________________

Have you ever been involuntarily terminated or asked to resign from any prior position of employment?

Yes No If Yes, please indicate: Name of Company? __________________________________________________

When? ________________________________ Why? _______________________________________________________

Have you been unemployed for a period of three consecutive months or more within the past five years? If so, please provide the dates of unemployment and explanation below:

Yes No Dates & Explanation: ___________________________________________________________________

Have you ever been employed by KPMG LLP and/or its members and affiliates worldwide in the last two years?*

Yes No When?__________________ Name of Company? _______________________ Location? ____________

Please state position: _________________________________________________________________________________

Were you a partner, the equivalent thereof, or a member of management for KPMG LLP in the last two years?*

Yes No

If you were a partner, equivalent thereof, or member of management, do you still have a financial interest in KPMG LLP?*

Yes No N/A *If you have answered yes to any of the three questions above, you must notify KPMG’s Department of Professional Practice (DPP) - Independence Group and present Citi with documentation showing that you have received clearance from KPMG to work for Citi.

EMPLOYMENT HISTORY

EMPLOYMENT ELIGIbILITY CONTINUED

Are you related to any member of the Citi Board of Directors, any executive officer of Citi, or anyone currently employed by Citi? Yes No

If Yes, Name: _______________________________________________________________________________________________

Name of Citi business unit: ________________________ Location: _________________ Nature of relationship:____________________

Are you related to any foreign official (defined to include any officer or employee of a foreign government or any department, agency, or instrumentality thereof, or of a public international organization, or any person acting in an official capacity for or on behalf of such entities)?

Yes No If Yes, Name of foreign official: _____________________________________ Nature of relationship: ________________

Government body/Organization: _________________________________________________ Country: __________________________

Page 4: Employment Application Package 1-17-11

EMPLOYMENT HISTORY, CONTINUED List all periods of employment, including volunteer and military service, for the last 10 years (if applicable). Start with your current or most recent position.

Are you presently employed? Yes No Is this your first job? Yes NoIn the event you receive and accept an offer of employment from Citi, your current employer will be contacted as part of the background check process.May we contact your current employer before your start date? Yes No

CURR

ENT O

R MO

ST R

ECEN

T EMP

LOYE

R Employer Type of Business Telephone (including country/area code)( )

Base Salary (final or most recent) $

Street Address City State Zip Last or Most Recent Bonus $

Full Job Title Dates Employed (Month & Year)

from / to /

Hours Per Week Overtime (list final or most recent annualized amount, if known)$

Nature of Duties Reason for Leaving Manager’s Name Commissions (list final or most recent annualized amount)$

PREV

IOUS

EM

PLOY

ER

Employer Type of Business Telephone (including country/area code)( )

Base Salary (final or most recent) $

Street Address City State Zip Last or Most Recent Bonus $

Full Job Title Dates Employed (Month & Year)

from / to /

Hours Per Week Overtime (list final or most recent annualized amount, if known)$

Nature of Duties Reason for Leaving Manager’s Name Commissions (list final or most recent annualized amount)$

PREV

IOUS

EM

PLOY

ER

Employer Type of Business Telephone (including country/area code)( )

Base Salary (final or most recent) $

Street Address City State Zip Last or Most Recent Bonus $

Full Job Title Dates Employed (Month & Year)

from / to /

Hours Per Week Overtime (list final or most recent annualized amount, if known)$

Nature of Duties Reason for Leaving Manager’s Name Commissions (list final or most recent annualized amount)$

PREV

IOUS

EM

PLOY

ER

Employer Type of Business Telephone (including country/area code)( )

Base Salary (final or most recent) $

Street Address City State Zip Last or Most Recent Bonus $

Full Job Title Dates Employed (Month & Year)

from / to /

Hours Per Week Overtime (list final or most recent annualized amount, if known)$

Nature of Duties Reason for Leaving Manager’s Name Commissions (list final or most recent annualized amount)$

PREV

IOUS

EM

PLOY

ER

Employer Type of Business Telephone (including country/area code)( )

Base Salary (final or most recent) $

Street Address City State Zip Last or Most Recent Bonus $

Full Job Title Dates Employed (Month & Year)

from / to /

Hours Per Week Overtime (list final or most recent annualized amount, if known)$

Nature of Duties Reason for Leaving Manager’s Name Commissions (list final or most recent annualized amount)$

725745 3022 (11/2010) Page 3 of 7 EMPLOYMENT APPLICATION CONT’D HUMAN RESOURCES

Page 5: Employment Application Package 1-17-11

EDUCATION

725745 3022 (11/2010) Page 4 of 7 EMPLOYMENT APPLICATION CONT’D

HIGH

SCH

OOL

Were you home schooled at the high school level?

Yes No

If Yes, did you receive a high school diploma or its equivalent?

Yes No

Provide the name of the issuing entity City State

Name of last high school attended

City State Did you receive a high school diploma? Yes No

Did you receive a GED?

Yes No

If Yes, provide the name of the entity that issued the GED

City State

POST

-SEC

ONDA

RY E

DUCA

TION

List all post-secondary school education including any trade or technical schools. List only accredited institutions.

Name of Institution #1

City State

Dates of attendancefrom (month/year): to (month/year): Did you graduate? Yes No

Did you receive a diploma or certificate from this institution? Yes No

Degree type Major Minor

If your education was received outside of the U.S. provide the following information if applicable: name and address of institution; full name and home address used while attending; letters, transcripts and diplomas from institution.

Name of Institution #2

City State

Dates of attendancefrom (month/year): to (month/year):

Did you graduate? Yes No

Did you receive a diploma or certificate from this institution? Yes No

Degree type Major Minor

If your education was received outside of the U.S. provide the following information if applicable: name and address of institution; full name and home address used while attending; letters, transcripts and diplomas from institution.

HUMAN RESOURCES

JOb-RELATED SKILLS

What computer programs are you familiar with? Typing WPM?

What office equipment do you operate?

What languages do you speak/read/write?

Please list any Accounting/Financial Courses/Skills. Please list any other job-related skills, knowledge and activities.

Do you have a securities, insurance, mortgage or commodities license with any domestic or foreign authority?

Yes No If Yes, list all such licenses and states, if any, where they are held: _________________________________________________

Please list any other professional licenses: ________________________________________________________________________________

________________________________________________________________________________

Page 6: Employment Application Package 1-17-11

CRIMINAL bACKGROUND INFORMATION

IF YOU ARE APPLYING FOR A POSITION IN MASSACHUSETTS, DO NOT FILL OUT THIS CRIMINAL bACKGROUND INFORMATION SECTION 7 PRIOR TO INTERVIEWING FOR A POSITION; IN HAWAII, DO NOT FILL IT OUT PRIOR TO RECEIVING A CONDITIONAL OFFER OF EMPLOYMENT.

If your prior criminal conviction(s) relate solely to an offense for driving under the influence, driving while impaired, or any other motor vehicle conviction which does not constitute a felony under applicable state law, please check this box and proceed to the next section.

If you are unsure if a situation requires disclosure, please list it.1. Have you ever been convicted of or pled guilty or “nolo contendre” (no contest) before any court to:

Any misdemeanor? Yes No

Any felony? Yes No

Any other criminal offense? Yes No

2. Have you ever been convicted of any offense by military court martial? Yes No

3. Have you ever been convicted of any offense in a foreign court? Yes No

4. Since November 29, 1990, have you participated in a pretrial diversion, delayed adjudication or similar program (including adjournment in contemplation of dismissal) for any criminal activity?

Yes No

HUMAN RESOURCES

For each conviction or pretrial diversion (or similar program) listed above, provide the following information (attach additional sheets if necessary). In addition, you may be required to provide copies of court documentation indicating the nature of the offense and its final disposition.

Date of conviction or program entry City County State

Criminal Offense with detailed explanation

Nature of offense (Misdemeanor or Felony)

Plea Or Disposition Sentence imposed (incarceration, probation, fine)

725745 3022 (11/2010) Page 5 of 7 EMPLOYMENT APPLICATION CONT’D

EDUCATION CONTINUED

POST

-SEC

ONDA

RY E

DUCA

TION

Name of Institution #3

City State

Dates of attendancefrom (month/year): to (month/year):

Did you graduate? Yes No

Did you receive a diploma or certificate from this institution? Yes No

Degree type Major Minor

If your education was received outside of the U.S. provide the following information if applicable: name and address of institution; full name and home address used while attending; letters, transcripts and diplomas from institution.

INSTRUCTIONS:In responding to the questions below, do not include any information on juvenile convictions.If you are hired, your responses will be verified by a criminal record check. A criminal conviction is not an automatic bar to employment. Factors such as legal and regulatory requirements, the relationship of the offense to employment, the length of time since the conviction, and the nature of the offense will be taken into account.Certain states limit your obligation to respond to questions concerning criminal convictions. Please review the following summaries of state law that may apply to you:CA applicants: Applicants in CA do not need to disclose convictions of: (1) marijuana offenses in violation of CA Health and Safety Code Sections 11357(b) or (c) or a statutory predecessor thereof, 11360(c), 11364, 11365 or 11550, as they related to marijuana prior to January 1, 1976 or a statutory predecessor thereof, which are more than two years old; or (2) any misdemeanor conviction for which probation has been successfully completed or otherwise discharged and the case has been judicially dismissed pursuant to CA Penal Code Section 1203.4.

CT applicants: Applicants in CT do not need to disclose the existence of any arrest, criminal charge or conviction for which records have been erased pursuant to Conn. Gen. Stat. Sections 46b-146, 54-760 or 54-142a. These records pertain to findings of delinquency; findings that a child was a member of a family with service needs; adjudications as a youthful offender; dismissed or nolled criminal charges; criminal charges for which they have been found not guilty; or convictions for which they have received pardons. Applicants whose criminal records have been erased are deemed never to have been arrested and may so swear.HI applicants: In HI, applicants should answer questions concerning convictions only after a conditional offer of employment has been made.MA applicants: Applicants in MA do not need to disclose: (1) a first conviction for drunkenness, simple assault, speeding, minor traffic violations, affray or disturbing the peace; or (2) misdemeanors where the date of conviction or the end of any period of incarceration was more than five years ago, provided that there have been no subsequent convictions within those five years.NY applicants: Applicants in NY must not disclose any criminal conviction if the conviction was sealed pursuant to Section 160.55 of the NY Criminal Procedure law or if the conviction is classified as a youthful offender adjudication under Section 720.35 of the NY Criminal Procedure law.

Page 7: Employment Application Package 1-17-11

REGULATORY INFORMATION

1. Has any court, the SEC, the CFTC, any state, any self-regulatory organization, national futures association or foreign financial regulatory authority, found you to have:

a) violated, or aided and abetted a violation of any investment-related (i.e., pertaining to securities, commodities, banking, insurance, or real estate, including being associated with a broker-dealer investment company, investment advisor, futures sponsor, bank or savings and loan association) statutes or regulations?

Yes No

b) made a false statement of a material fact, or failed to state any material fact in any (i) application for registration, or (ii) report required under federal or state securities laws or substantially equivalent foreign laws or the rules of any self-regulatory organization, or (iii) proceeding before the SEC or any domestic or foreign court, concerning an investment-related matter?

Yes No

c) engaged in any dishonest, unfair or unethical practice? Yes No

d) been a cause of an investment-related (as defined above) business having its authorization to do business denied, suspended, revoked or restricted?

Yes No

(e) willfully violated, or willfully aided, abetted, counseled, commanded, induced, or procured the violation by any person of, or found you to have failed to reasonably supervise another person subject to your supervision with a view to preventing the violation, any provision of the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under any of such Acts, or any of the rules of the Municipal Securities Rulemaking Board, or found you to have been unable to comply with any provision of such Act, rule or regulation.

Yes No

2. Has the SEC, the CFTC, any state, any self-regulatory organization, national futures association, or any foreign financial regulatory authority ever:

(a) denied you membership or registration? Yes No

(b) taken any disciplinary action against you or found that you were the cause of a disciplinary action taken against another person or firm? Yes No

(c) imposed any sanction (including censure, suspension, and expulsion, but not letters of caution or admonition) upon you for a violation of any law, regulation, or rule?

Yes No

(d) made you the subject of any proceedings for denial, suspension, revocation of membership or registration? Yes No

(e) found that you were the cause of any suspension, revocation or order taken against another person or firm? Yes No

3. To the best of your knowledge, has any (a) member of a national securities or commodities exchange, national futures association or contract market, (b) broker-dealer, or (c) substantially equivalent foreign entity with which you have been associated in any capacity, at the time of your association:

(a) been denied membership in a national securities exchange, national securities association, or foreign financial regulatory authority? Yes No

(b) been suspended or expelled from membership in a national securities exchange, national securities association or foreign financial regulatory authority?

Yes No

(c) been denied registration by the SEC or foreign securities regulatory authority or had such authority suspended or revoked? Yes No

(d) been denied registration or a license by any state agency or had such registration or license suspended or revoked? Yes No

4. Are you presently the subject of any proceedings in which an adverse decision would result in any of the above questions being answered “Yes”?

Yes No

5. Within the past 10 years, has a bonding company ever denied, paid out on, or revoked a bond for you? Yes No

For any “YES” answer, please provide full details, by question number, including a record of any action taken against you and disposition of any matter or proceeding, on an additional sheet.

6. Have you ever been subject to any final order of a state securities commission (or any agency or office performing like functions), state authority that supervises or examines banks, savings associations, or credit unions, state insurance commission (or agency or office performing like functions), an appropriate federal banking agency, or the National Credit Union Administration that bars you from association with any entity regulated by such commission, authority, agency, or officer, or from engaging in the business of securities, insurance, banking, savings association activities, or credit union activities, or constitutes a final order based on violations of any laws or regulations that prohibit fraudulent, manipulative, or deceptive conduct?

Yes No

7. Have you ever had an authorization to act as an attorney, accountant or federal contractor that was revoked or suspended? Yes No

725745 3022 (11/2010) Page 6 of 7 EMPLOYMENT APPLICATION CONT’D HUMAN RESOURCES

Page 8: Employment Application Package 1-17-11

725745 3022 (11/2010) Page 7 of 7 EMPLOYMENT APPLICATION CONT’D HUMAN RESOURCES

ACKNOWLEDGEMENT

I acknowledge that the information I have provided on this employment application is true and complete and will be verified. I understand that any falsification or omission of information on this application or during the interview or hiring process, no matter when discovered, shall constitute grounds for denial of employment or immediate termination of employment.

I authorize any inquiry to be made on the information contained in the application. Former employers and educational institutions are authorized to provide information about me and I hereby release them from all liability and waive any privilege I have to such information. I authorize any sharing of this information along with other investigative information among affiliates. I understand that this application is not an offer or contract of employment, and that nothing stated during any interview, or contained in any Citi policy, procedure or handbook that I may receive, creates a contractual relationship with or contractual obligation on the part of Citi (except as described below). I understand that if hired, my employment with Citi is “at will”, and can be terminated by me or by Citi at any time, with or without prior notice, for no reason or any reason not otherwise prohibited by law (subject to any applicable Employment Termination Notice Policy).

I understand that Citi may require a transfer or relocation as a condition of my employment.

Notwithstanding anything to the contrary herein, I understand that Citi has adopted: (1) an employment arbitration policy, described in applicable employee handbooks and in the Principles of Employment, which requires me to submit any and all disputes related to my employment or the termination of my employment to binding arbitration; and, (2) a Code of Conduct which describes Citi’s business practices and its commitment to its clients, its employees, and its franchise. I understand that the employment arbitration policy is a mutual agreement between Citi and me. I understand and agree to be bound by the Principles of Employment and the Code of Conduct, and that as a term and condition of my employment with Citi, I must indicate my acceptance to the Principles of Employment and Code of Conduct.

I understand that any offer of employment is contingent on: (1) successful completion of a pre-employment drug screening and, where applicable, a physical exam; (2) successful completion of any and all reference, financial, credit and background checks (which will include a consumer report provided by a consumer reporting agency and a criminal background check); (3) my providing appropriate work authorization and completing an “I-9 form” within the time period prescribed by law, and where required by law, providing proof of age; (4) my ability to satisfy any applicable bonding requirements; (5) completion of the Letter of Assurance for Foreign and National Employees; (6) if I am licensed, verification of any license(s) and/or registration(s), and the absence of any violation, fine, suspension or other regulatory action taken against me; and (7) successful completion of any additional documentation and examinations required by Citi as a condition of employment.

I represent that: (1) I am legally free to enter into an employment relationship with Citi; (2) I have no obligation to any other person or entity that would affect or conflict with my employment with Citi; and, (3) my employment with Citi will not breach any contractual obligation or violate any law, rule, regulation, order, or decree. I further represent that, if I am hired, I will disclose to Citi any current or future outside business interests for the purpose of determining compliance with regulatory standards and Citi policy, and understand that certain affiliations or activities may be impermissible under such standards and/or policy.

I understand that Citi will make reasonable accommodation for a qualified applicant or employee with a disability unless it would cause an undue hardship. It is my obligation if I am a person with a disability to request reasonable accommodation if needed.

Signature Date

Page 9: Employment Application Package 1-17-11

te

Applicant SurveyWork Opportunity Tax Credit and Welfare to Work Tax Credit Programs

Citigroup is participating in the Work Opportunity Tax Credit and Welfare to Work Tax Credit programs. These programs are designed by the federal government to help companies hire more people into the workforce and to retain employees through federal incentives.

Your response to the question below will help us determine if Citigroup may qualify for these programs. Any information you provide will be kept confi dential and will not affect your job, wages, or taxes. Thank you in ad-vance for your time and participation.

Check here if any of the following statements apply to you:� I am a member of a family that has received Temporary Assistance for Needy Families (TANF)

for any of the following: � During the last four years � Stopped being eligible for TANF within the last two years because of limitations on

how long the benefi t could be received

� I was referred here by a rehabilitation agency approved by the state or the Department of Veteran Affairs.

� I am either a veteran or I am 18-24 years of age and I am a member of a family that received food stamps within the last two years.

� I received Supplemental Security Income (SSI) benefi ts within the last two months.

� Within the past year, I was convicted of a felony and during the last 6 months I was a member of a low-income family.

Name ____________________________________________ Date _____________

Please return this form to Human Resources along with your employment application.

Page 10: Employment Application Package 1-17-11

Revised 03/31/09

CONSUMER REPORT/ INVESTIGATIVE CONSUMER REPORT DISCLOSURE AND FBI CRIMINAL HISTORY CHECK NOTICE

By this document, Citigroup Inc. or one of its subsidiaries or their affiliates (“Citi”) discloses to you that upon acceptance of an offer of employment, for employment purposes, and as part of its background investigation before or during your employment, and periodically as may be required by law in connection with your employment, (1) a consumer report and/or consumer investigative report will be obtained about you from a Consumer Reporting Agency (CRA) and (2) your fingerprints will be used to check the criminal history records of the Federal Bureau of Investigation (FBI).

A consumer report, as defined by the Fair Credit Reporting Act (FCRA), is a written or oral report or other communication prepared by a CRA that may include a summary of your credit standing, credit capacity, credit worthiness, debts, or check-writing experience; insurability; character; general reputation; personal characteristics or mode of living. An investigative consumer report is a report prepared by a CRA that may contain information regarding your character, general reputation, personal characteristics, or mode of living obtained through any means, including personal interviews with your friends, neighbors or associates or with others with whom you are acquainted or who may have knowledge concerning any such items of information.

The consumer report and/or consumer investigative report will be provided to Citi by the following CRA: Business Information Group P.O. Box 541 Southampton, PA 18966 Telephone 1-800-260-1680

It may consist of the following types of information: credit reports, social security number verification, criminal history check, court records check, driving records check, educational records check, personal and professional references checks, licensing and certification checks, and verification of employment positions held. You will be advised by Citi of any adverse employment action (including denial or termination of your employment) taken against you based in whole or in part on such a report.

FOR CALIFORNIA APPLICANTS AND EMPLOYEES ONLY: Under applicable state law, you have the right to receive a copy of your consumer report and/or consumer investigative report. FOR ALL OTHER APPLICANTS AND EMPLOYEES: Under applicable state law, you may have the right to receive a copy of your consumer report and/or consumer investigative report.

You may obtain a copy of the consumer report and/or consumer investigative report that is provided to Citi by calling the phone number provided on the attached Consumer Report/Investigative Consumer Report Release and Authorization form.

You also may contact Business Information Group directly at the address above if you wish to request additional information on the nature and scope of the report(s), to obtain a copy of the file maintained by them, or to dispute any information contained in the report(s). A “Summary of Your Rights Under the Fair Credit Reporting Act” is attached for your reference; you also may have additional rights under applicable state law. FOR CALIFORNIA APPLICANTS AND EMPLOYEES ONLY: These rights are explained in the attached “Summary of Your Rights under the California Investigative Consumer Reporting Agencies Act”.

Please review the enclosed Consumer Report/ Investigative Consumer Report Release and Authorization form, and return a signed copy of the form to your recruiting/ staffing contact or Human Resources representative with the other completed documents in your application package.

Page 11: Employment Application Package 1-17-11

Revised 03/31/09

A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT

Para información en español, visite www.ftc.gov/credit o escribe a la FTC Consumer Response Center, Room 130-A 600 Pennsylvania Ave. N.W., Washington, D.C. 20580.

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.ftc.gov/credit or write to: Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Ave. N.W., Washington, D.C. 20580.

You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.

You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if: a person has taken adverse action against you because of information in your credit report; you are the victim of identify theft and place a fraud alert in your file; your file contains inaccurate information as a result of fraud; you are on public assistance; you are unemployed but expect to apply for employment within 60 days. In addition, by September 2005 all consumers will be entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.ftc.gov/credit for additional information.

You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.

You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.ftc.gov/credit for an explanation of dispute procedures.

Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.

Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.

Access to your file is limited. A consumer reporting agency may provide information about you only to people

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with a valid need -- usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.

You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.ftc.gov/credit.

You may limit “prescreened” offers of credit and insurance you get based on information in your credit report. Unsolicited “prescreened” offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-5-OPTOUT (1-888-567-8688).

You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.

Identity theft victims and active duty military personnel have additional rights. For more information, visit www.ftc.gov/credit.

States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. Federal enforcers are:

TYPE OF BU SINESS: CONTACT: Consumer reporting agencies, creditors and others not listed below Federal Trade Commission: Consumer Response Center - FCRA

Washington, DC 20580 1-877-382-4357

National banks, federal branches/agencies of foreign banks (word "National" or initials "N.A." appear in or after bank's name)

Office of the Comptroller of the Currency Compliance Management, Mail Stop 6-6 Washington, DC 20219 800-613-6743

Federal Reserve System member banks (except national banks, and federal branches/agencies of foreign banks)

Federal Reserve Board Division of Consumer & Community Affairs Washington, DC 20551 202-452-3693

Savings associations and federally chartered savings banks (word "Federal" or initials "F.S.B." appear in federal institution's name)

Office of Thrift Supervision Consumer Complaints Washington, DC 20552 800-842-6929

Federal credit unions (words "Federal Credit Union" appear in institution's name)

National Credit Union Administration 1775 Duke Street Alexandria, VA 22314 703-519-4600

State-chartered banks that are not members of the Federal Reserve System

Federal Deposit Insurance Corporation Consumer Response Center, 2345 Grand Avenue, Suite 100 Kansas City, Missouri 64108-2638 1-877-275-3342

Air, surface, or rail common carriers regulated by former Civil Aeronautics Board or Interstate Commerce Commission

Department of Transportation , Office of Financial Management Washington, DC 20590 202-366-1306

Activities subject to the Packers and Stockyards Act, 1921 Department of Agriculture Office of Deputy Administrator - GIPSA Washington, DC 20250 202-720-7051

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FOR CALIFORNIA APPLICANTS AND EMPLOYEES ONLY:

A SUMMARY OF YOUR RIGHTS UNDER THE CALIFORNIA INVESTIGATIVE CONSUMER REPORTING AGENCIES ACT

You also have the following rights under the California Investigative Consumer Reporting Agencies Act in connection with inspecting an investigative consumer report maintained on you by an investigative consumer reporting agency (“CRA”):

At your request and upon presenting proper identification, the CRA must allow you, during normal business hours and upon reasonable notice, to visually inspect all files maintained regarding you (except that sources of information, other than public records and records from data bases available for sale, acquired solely for use in preparing an investigative consumer report and actually used for no other purpose, need not be disclosed except under discovery procedures in any civil action brought under the Investigative Consumer Reporting Agencies Act (Civil Code section 1786 et seq.).

The CRA must disclose to you the recipients of any investigative consumer report furnished for employment or any other purposes within the three-year period preceding the request.

Files maintained on you shall be available for your inspection as follows:

1. You may inspect your file(s) in person if you appear and furnish proper identification. Proper identification includes documents such as a valid driver’s license, social security account number, military identification card, and credit cards. A copy of your files shall also be available to you for a fee not to exceed the actual costs of duplication services provided.

2. You may obtain a copy of your file by certified mail if you make a written request with proper identification for copies to be sent to a specified addressee. A CRA complying with a request for a certified mailing is not liable for disclosure to third parties caused by mishandling of mail after the mailing leaves the CRA.

3. A summary of all information contained in your files that you have a right to receive shall be provided by telephone, if you have made a written request, with proper identification for telephone disclosure, and the toll charge, if any, for the telephone call is prepaid by or charged directly to you.

4. The CRA must provide trained personnel to explain to you any information that you have a right to receive.

5. The CRA must provide a written explanation of any coded information contained in files maintained on you. This written explanation must be distributed whenever a file is provided to you for visual inspection as discussed above.

6. You have a right to be accompanied by one other person of your choosing, who shall furnish reasonable identification when inspecting your file. A CRA may require you to furnish a written statement granting permission to the CRA to discuss your file in another person’s presence.

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FOR NEW YORK STATE APPLICANTS AND EMPLOYEES ONLY:

NEW YORK CORRECTION LAW ARTICLE 23-A

LICENSURE AND EMPLOYMENT OF PERSONS PREVIOUSLY CONVICTED OF ONE OR MORE CRIMINAL OFFENSES

§750. Definitions.

§751. Applicability.

§752. Unfair discrimination against persons previously convicted of one or more criminal offenses prohibited.

§753. Factors to be considered concerning a previous criminal conviction; presumption.

§754. Written statement upon denial of license or employment.

§755. Enforcement.

§750. Definitions. For the purposes of this article, the following terms shall have the following meanings:

(1) "Public agency" means the state or any local subdivision thereof, or any state or local department, agency, board or commission.

(2) "Private employer" means any person, company, corporation, labor organization or association which employs ten or more persons.

(3) "Direct relationship" means that the nature of criminal conduct for which the person was convicted has a direct bearing on his fitness or ability to perform one or more of the duties or responsibilities necessarily related to the license, opportunity, or job in question.

(4) "License” means any certificate, license, permit or grant of permission required by the laws of this state, it’s political subdivisions or instrumentalities as a condition for the lawful practice of any occupation, employment, trade, vocation, business, or profession. Provided, however, that "license" shall not, for the purposes of this article, include any license or permit to own, possess, carry, or fire any explosive, pistol, handgun, rifle, shotgun, or other firearm.

(5) "Employment" means any occupation, vocation or employment, or any form of vocational or educational training. Provided, however, that "employment" shall not, for the purposes of this article, include membership in any law enforcement agency.

§751. Applicability. The provisions of this article shall apply to any application by any person for a license or employment at any public or private employer, who has previously been convicted of one or more criminal offenses in this state or in any other jurisdiction, and to any license or employment held by any person whose conviction of one or more criminal offenses in this state or in any other jurisdiction preceded such employment or granting of a license, except where a mandatory forfeiture, disability or bar to employment is imposed by law, and has not been removed by an executive pardon, certificate of relief from disabilities or certificate of good conduct. Nothing in this article shall be construed to affect any right an employer may have with respect to an intentional misrepresentation in connection with an application for employment made by a prospective employee or previously made by a current employee.

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§752. Unfair discrimination against persons previously convicted of one or more criminal offenses prohibited. No application for any license or employment, and no employment or license held by an individual, to which the provisions of this article are applicable, shall be denied or acted upon adversely by reason of the individual’s having been previously convicted of one or more criminal offenses, or by reason of a finding of lack of "good moral character" when such finding is based upon the fact that the individual has previously been convicted of one or more criminal offenses, unless:

(1) There is a direct relationship between one or more of the previous criminal offenses and the specific license or employment sought or held by the individual; or

(2) the issuance or continuation of the license or the granting or continuation of the employment would involve an unreasonable risk to property or to the safety or welfare of specific individuals or the general public.

§753. Factors to be considered concerning a previous criminal conviction; presumption. 1. In making a determination pursuant to section seven hundred fifty-two of this chapter, the public agency or private employer shall consider the following factors:

(a) The public policy of this state, as expressed in this act, to encourage the licensure and employment of persons previously convicted of one or more criminal offenses.

(b) The specific duties and responsibilities necessarily related to the license or employment sought or held by the person.

(c) The bearing, if any, the criminal offense or offenses for which the person was previously convicted will have on his fitness or ability to perform one or more such duties or responsibilities.

(d) The time which has elapsed since the occurrence of the criminal offense or offenses.

(e) The age of the person at the time of occurrence of the criminal offense or offenses.

(f) The seriousness of the offense or offenses.

(g) Any information produced by the person, or produced on his behalf, in regard to his rehabilitation and good conduct.

(h) The legitimate interest of the public agency or private employer in protecting property, and the safety and welfare of specific individuals or the general public.

2. In making a determination pursuant to section seven hundred fifty-two of this chapter, the public agency or private employer shall also give consideration to a certificate of relief from disabilities or a certificate of good conduct issued to the applicant, which certificate shall create a presumption of rehabilitation in regard to the offense or offenses specified therein.

§754. Written statement upon denial of license or employment. At the request of any person previously convicted of one or more criminal offenses who has been denied a license or employment, a public agency or private employer shall provide, within thirty days of a request, a written statement setting forth the reasons for such denial.

§755. Enforcement. 1. In relation to actions by public agencies, the provisions of this article shall be enforceable by a proceeding brought pursuant to article seventy-eight of the civil practice law and rules. 2. In relation to actions by private employers, the provisions of this article shall be enforceable by the division of human rights pursuant to the powers and procedures set forth in article fifteen of the executive law, and, concurrently, by the New York city commission on human rights.

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CONSUMER REPORT/ INVESTIGATIVE CONSUMER REPORT RELEASE AND AUTHORIZATION

I have received from Citigroup Inc. or one of its subsidiaries or their affiliates (the “Company”) a copy of the Consumer Report/ Investigative Consumer Report Disclosure and FBI Criminal History Check Notice (“Notice”) and a “Summary of Rights under the Fair Credit Reporting Act”, and, if I am a California applicant or employee, a “Summary of Your Rights under the California Investigative Consumer Reporting Agencies Act“, and, if I am a New York State applicant or employee, “New York Correction Law Article 23-A“.

I authorize Citi and Business Information Group (“BIG”) to obtain a consumer report and/ or investigative consumer report (as defined in the Notice) about me for employment purposes as part of Citi’s background investigation of me before or during my employment with Citi, and periodically as may be required by law in connection with my employment. I further authorize Citi and/or BIG to provide my fingerprints and any consumer report or investigative consumer report about me to any federal or state agency as may be required by law in connection with my employment.

I authorize all corporations, companies, and persons to release information they may have about me to Citi or to BIG. Further, I release from any and all liability all corporations, companies and persons requesting or providing such information.

FOR CALIFORNIA APPLICANTS AND EMPLOYEES ONLY: I understand that I have the right to obtain a copy of my consumer report and/or investigative consumer report upon request, at no charge to me, and that I will be provided with a free copy of such report(s) if I contact BIG at the phone number below. FOR ALL OTHER APPLICANTS AND EMPLOYEES: I understand that I may have the right to obtain a copy of my consumer report and/or investigative consumer report upon request, at no charge to me, and that I will be provided with a free copy of such report(s) if I contact BIG at the phone number below.

A copy of this document will have the same authority as the original.

Date Signature

Print name

To request a copy of the consumer report and/or investigative consumer report provided to Citi at no charge, please call BIG’s Consumer Disclosure department at 1-800-260-1680.


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