133693 - Technician, B FR-SS01D

Apr 20, 2023

Personal Information

Please complete and review the information below and click the forward arrow at the bottom to continue.

Personal Information

Legal First Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Myles

Legal Middle Name (If no middle name, leave blank) . David
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Legal Last Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Gallon
Address Line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Memphis Ct
Address Line 2 (optional) .
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City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sicklerville
Country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . United States
State/Province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Jersey
Zip/Postal Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 08081
Primary Telephone Phone (nnn-nnn-nnnn) . (856) 481-5950
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General Information

Have you ever worked at or supported IEH Auto Plus LLC or The Pep Boys -
Manny, Moe & Jack, or any of their subsidiaries as a permanent employee, No
temporary employee, contractor, or intern?
Please explain further by indicating your employment status (permanent,
temporary, contractor, or intern), dates of employment, and
manager/supervisor name(s).
Are you at least 18 years of age? Yes
Do you currently have the legal right to work in the United States? Yes
Have you signed any non-compete or non-solicit agreements with any other
employer that might restrict you from working for IEH Auto Plus LLC, The Pep
No
Boys- Manny, Moe & Jack, or any of it's subsidiaries? You also may be
required to furnish a copy of the agreement.
If yes, please explain:
Are you a relative of any Company employee? No
If yes, provide name, relationship, and location of employee.
Are you able to perform, with or without reasonable accommodation, the
Yes
essential functions of the job for which you are applying?
The Company will work with an otherwise qualified individual to reasonably accommodate his or her disability. Job applicants should direct all requests for accommodations to Human Resources in New
York.

In the future will you require sponsorship for employment visa status (e.g.
No
H-1B visa status)?
If yes, state work permit or visa type and expiration date.
Immigration Reform and Control Act (IRCA)

The Immigration Reform and Control Act (IRCA) prohibits the employment of unauthorized aliens and further requires that if you are hired, the Company must verify your identity and your
authority to work in the United States, even if you are a U.S. citizen. You are responsible for obtaining and providing the documentation required to perform the verification. (Information
concerning this verification procedure and requirements is available upon request.)

Icahn Automotive Group LLC (the "Company"), will make all employment decisions regarding employees and applicants for employment without discrimination or harassment based on race, color,
religion, gender, national origin, sexual orientation, age, disability, pregnancy, marital status, veteran status, alienage or citizenship status, creed, genetic predisposition or carrier status, status
as a victim of domestic violence, or any other category protected by federal, state, or local law.

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Employment History

Note: Account for your last five years of employment history (most recent first including periods of self-employment).

Click the "Add Previous Employer" button below to add additional employers. If you have only one employer, then please fill in the
required fields below and click the red arrow button to the right.

*= System Required
*= Conditionally Required based off previous answer

Previous Employer 1
Employment Type .
.....................................................
Current
If you do not have any prior experience, select "No Previous Experience"
from the dropdown. No other fields will be required.
Name of Employer * DoorDash

Job Title * Delivery Driver

Employer Phone *
 (855) 431-0459
nnn-nnn-nnnn
City * Palo Alto

Country * United States

State* California

Supervisor's Name * N/A

Start Date (please select the first day of the month if you do not recall the
08/01/2018
exact date)*
End Date (please select the first day of the month if you do not recall the
04/03/2023
exact date)
Describe work performed and scope of responsibilities. * Delivery Driver UberEATS, DoorDash August 2018 to Present Mobile Delivery
May we contact this employer? Yes

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Education History
To add additional education, click the Add Education button below. The Remove Last Education will delete all entries for the last education that you have entered.

Please enter your highest level of education completed first.

*= System Required
*= Conditionally Required based off previous answer

Education 1
Education Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . High School Graduate
School/University Name * Winslow High School

Did you graduate? * Yes

City * Acto

Country * United States

State/Province * New Jersey

Major/Field of Study * N/A

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ASE Licenses
One of the key distinctions that separate Pep Boys from our competition is the talent and professionalism of our associates. ASE (Automotive Service Excellence) certification demonstrates your commitment
to the automotive service and repair profession. Receiving ASE certification shows your peers, supervisors, and the general public your commitment to your chosen career and your ability to perform to set
standards. You are required to obtain and maintain certain ASE Certifications for your position within two ASE testing cycles or your future compensation may be impacted. Pep Boys will support your effort
to obtain ASE Certifications by prepaying for all ASE Registration and Testing fees and paying for your time to take tests in order to meet the requirements for your position.

To add additional professional licenses, click the Add License button below. The Remove Last License will delete all entries for the last license that you have entered.

Licenses 1
License Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OTHER
If License Not Listed Add Name of License N/A
License Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G03035716405002
License Agency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NJMVC
Issue Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12/30/2021
Expiration Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05/01/2025
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Jersey

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eSignature

Please read, sign, and acknowledge where applicable, then click on the forward arrow to continue with the process

I certify that all the information I have provided on this application is true and complete to the best of my knowledge. I understand that omitting requested information or giving false or
misleading information on my application (even if I believed the information to be true), in my interview(s), or in the process of my pre-employment evaluation may result in rejection of my
application or termination of employment. I authorize the Company to verify the information I have provided in this application and, if I am hired, I authorize continuing investigation of all
statements contained in this application, consistent with applicable law.

I understand that employment and continued employment is subject to satisfactory completion of a background check and proof of my authorization to work in the United States, all conducted
and/or required in accordance with applicable laws. Past conviction of a crime is not an automatic bar to employment. The nature, time since conviction, disposition of conviction and other
factors deemed relevant by the Company for the position will be considered as it relates to the job you are seeking and consistent with applicable law.

To the maximum extent permitted by law, I hereby release and hold harmless all persons and entities, including my present employer, requesting or supplying information about my
background and, to the maximum extent permitted by law, I also release the Company and any contractor or vendor retained by the Company from all liability in connection with the conduct of
a background check in connection with my application for employment.

Notwithstanding the foregoing, I understand that this Application of Employment does not constitute an offer of employment by the Company. Employment with the Company is for an
indefinite and unspecified duration. If I am hired, I may leave employment at will, and the Company may discharge me or any or all other employees at any time, without notice, and for any
reason not prohibited by law.

I agree that any claim or lawsuit relating to my application for employment and, if applicable, employment or termination from employment with the Company must be filed no more than six (6)
months after the date of the employment action that is the subject of the claim or lawsuit. I waive any statute of limitation to the contrary to the maximum extent permitted by law.

I acknowledge that I have carefully read all of the above, acknowledge and understand what I am signing. I understand that an electronic signature has the same effect and validity as a written
signature.

eSignature
Please type your name in the acknowledgement box below as follows: Myles David Gallon
Then select Accept to continue. Selecting Decline means you do not accept and you will not be able to continue with the application process.
Acknowledgement . Myles Gallon
..................................................... Accepted
FOR ARIZONA APPLICANTS: PURSUANT TO ARIZ. REV. STAT § 36-601.01, THE COMPANY MAINTAINS A SMOKE-FREE WORKPLACE.

FOR RHODE ISLAND APPLICANTS: THE COMPANY IS SUBJECT TO CHAPTER 29-38 OF TITLE 28 OF THE GENERAL LAWS OF RHODE ISLAND AND IS THEREFORE COVERED BY THE STATE'S WORKERS'
COMPENSATION LAW.

FOR MASSACHUSETTS APPLICANTS: I ACKNOWLEDGE THAT IT IS UNLAWFUL IN

MASSACHUSETTS TO REQUIRE OR ADMINISTER A LIE DETECTOR TEST AS A
CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. AN EMPLOYER
WHO VIOLATES THIS LAW SHALL BE SUBJECT TO CRIMINAL PENALTIES AND
Yes
CIVIL LIABILITY.

I acknowledge the above statement

FOR MARYLAND APPLICANTS: I ACKNOWLEDGE THAT, UNDER MARYLAND LAW,

AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF
EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONTINUED EMPLOYMENT,
THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST.
AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND Yes
SUBJECT TO A FINE NOT EXCEEDING $100.

I acknowledge the above statement

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