24-2592 - M013-Cust Service Agent BIL-M

Feb 20, 2025

Personal Information

Personal Information

Legal First Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mario

Legal Last Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lopez
Second Last Name . Rodriguez
.....................................................
Email Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . cesarlr0028@gmail.com
Address 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Las Palmas 5592
Address 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Monterrey
County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cumbres
Country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mexico
State/Province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nuevo León
Zip/Postal Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64610
Primary Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01 81 1311 0511
Secondary Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General Information

Date of Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11/28/2000

If hired, can you provide proof of your legal right to work in Mexico? Yes
Have you ever worked for Afni, Inc or Afni Insurance Services before? No
Are you bilingual? Yes
If yes and applicable, which languages are you fluent in? English, Spanish
Employment History

Employment History

Please enter all employment history. Employment history will be a factor in our hiring decision.

Please list your most recent employer first. To add additional employers, click the Add Employer button below. The Remove Last Employer will delete all entries for the last employer that you have
entered.

If you have no employment history, please choose N/A in the Employer Type dropdown.

Previous Employer 1
Employer Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Previous
Name of Employer* . Hannie
.....................................................
Type of Industry* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other
Position/Title* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fruits and vegetables assistant
Country* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mexico
State* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nuevo León
City* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Monterrey
Enter a valid city with correct spelling. Do not enter "Remote" as a city.

Start Date* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12/12/2024

End Date* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01/10/2025
Reason for leaving this employer* . Job Satisfaction
.....................................................
May We Contact?* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No
Supervisor Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . David
Supervisor Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Previous Employer 2
Employer Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Previous
Name of Employer* . Michelle
.....................................................
Type of Industry* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other
Position/Title* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . General employee
Country* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mexico
State* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nuevo León
City* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Monterrey
Enter a valid city with correct spelling. Do not enter "Remote" as a city.

Start Date* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05/21/2022

End Date* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 06/21/2024
Reason for leaving this employer* . Job Satisfaction
.....................................................
May We Contact?* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No
Supervisor Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hernan
Supervisor Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Education History

Education

Degree . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HS Graduate or Equivalent

Field of Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date Completed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Development Training (ALPS training)

Relevant training and certifications and dates.

Computer Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Terms and Conditions - Searchlook
TERMS AND CONDITIONS OF USE

Please click here to review the Terms and Conditions of Use

Acknowledgement . Yes
.....................................................
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PRIVACY NOTICE FOR USERS

Please click here to review the Privacy Notice for Users

Acknowledgement . Yes
.....................................................
I agree to Searchlook® Terms and Conditions of Use and Privacy Notice
Signature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mario Lopez
Please enter your first and last name Accepted
eSignature

Electronic Signature

ELECTRONIC SIGNATURE NOTICE AND CONSENT

This notice is intended to provide you with important information required by the Electronic Signatures in Global and National Commerce Act (E‐Sign Act).

Consent: By entering your name, you consent to submit your employment application and all related forms, documents and information electronically. You further consent to conduct any
matters related to the recruiting, application, background check and/or onboarding process electronically. Typing your name in the textbox under or on a form, entering your login password,
and clicking on "Submit", will constitute your electronic signature.

Right to Withdraw Your Consent: You have the right to withdraw your consent to receive disclosures and submit information electronically. If you choose to withdraw your consent, the
application process will be terminated. You may withdraw your consent by contacting the Company, and typing in "Withdraw" in the textboxes for the Certification and Background Disclosure
pages.

Technical Requirements: To use this online process and to access and retain electronic records, you will need Microsoft Internet Explorer 7.0 or 8. You must also have access to a printer and/or
the ability to download information in order to keep copies of the electronic agreements and disclosures for your records.

Paper Copies of Electronic Records: If you wish to obtain a free copy of your electronic application and disclosure forms, you may click on the "print" link on the manage your application page.

Updating contact information: It is your responsibility to update the Company regarding any changes to your e‐mail address or other contact information.

Applicant Statement

I hereby certify that all of the foregoing statements are true and complete. I agree to assume a continuing responsibility to disclose additional or new information, called for this Employment
Application, but known to me only after this Application was completed, and understand that my failure to make such disclosure, and that false, incomplete or misleading information given on
this Application, on any employment form, or in any interview, are grounds for terminating the employment process or, if discovered after employment, terminating employment.

I expressly agree to reimburse AMXI-Afni Mexico Entity for attorney fees, costs and expenses incurred in its successfully defending all or part of any state or federal court lawsuit that I may file
against AMXI-Afni Mexico Entity and/or any individual in their capacity as an agent of AMXI-Afni Mexico Entity, arising out of or in connection with this Application, the hiring process and/or
any employment that I accept at AMXI-Afni Mexico Entity. I also agree, as does AMXI-Afni Mexico Entity, to waive all rights to a trial by jury on any claim one may assert against the other in a
court of law. Additionally, I agree that any claim that I may assert against AMXI-Afni Mexico Entity in a court of law shall be brought only in my individual capacity and not as a plaintiff or class
member in a class or representative proceeding.

I understand that if I am employed, my employment will not be for a definite duration and can be terminated at any time by either AMXI-Afni Mexico Entity or myself. I further understand that
none of AMXI-Afni Mexico Entity's personnel policies should be construed as a contract or as a guarantee of continued employment. No representative of AMXI-Afni Mexico Entity or its
subsidiaries or affiliates, other than AMXI-Afni Mexico Entity's President, has authority to enter into or approve any agreement for employment for any specific period of time or to approve any
agreement contrary to the foregoing.

Additionally, I understand that the invalidity or unenforceability of any particular provision of this Applicant Statement will not affect the Applicant Statement's other provisions, which are then
to be applied as if the invalid or unenforceable provision were omitted.

Please type your full legal name as you listed it on this application Mario Lopez.
Mario Lopez
ELECTRONIC SIGNATURE: Accepted

I testify that this statement is true to the best of my knowledge.