EMPLOYMENT OPERATIONS CANVASS INSTRUCTIONS

1 180 Livingston Street Brooklyn, NY 11201 EMPLOYMENT OPERATIONS CANVASS INSTRUCTIONS We are canvassing names on the exam list referenced in the email sent to you from MTA NYCT in anticipation of making appointments. In order for you to be considered for this position, you must respond to this CANVASS , complete the enclosed pre- EMPLOYMENT application form and submit any required document(s) to indicate your interest. Your name on all documents submitted must match. Your response must be sent to the email address provided no later than the date indicated in the email. Failure to respond will result in your name being removed from the list. This is not an offer of EMPLOYMENT Please Do Not Resign from your present EMPLOYMENT until you have received a job offer and start date.

2 I am interested in this job (check the box). Complete the enclosed pre- EMPLOYMENT application form and submit it along with this letter, and a copy of the documents indicated below to the email address that was provided to you). (You must read all INSTRUCTIONS and complete all pages. Incomplete applications will not be accepted.) You can complete, sign and save the fillable application on your computer or tablet. Some sections may not be fillable as the information is not applicable at this time. You must include any Unemployment time when filling out the application. If you claimed Veterans Credits, submit your DD-214 (Discharge Paper). If you claimed Disability Credits, submit your disability letter from the Veterans Administration.

3 If you claimed Legacy Credits, submit a 9/11 Legacy Credit Letter from either the FDNY or NYPD. If your title requires a High School Diploma or , submit a copy. If your title requires a Driver s License, CDLB License and/or Permit, submit a copy. If you have had Drivers License in a state other than NY or NJ within the last three years you mustsubmit the out of state abstract/ driver s record. This document cannot be more than 30 days old. See Job Description for further information of position with drivers license requirements. You must email the completed application, this letter, and a copy of the required documents. You must make a copy of the application and keep for your records.

4 I am not interested in this job (check the box and Do Not complete any additional documents). Return this notice to the email address provided in the email sent to you. Write your Full Name, Exam Number, List Number and the last five digits of your social security number. Name _____ Exam Number _____ List Number _____ Last 5 digits of SSN _____ After your documents have been received, you will be contacted and notified of any additional steps that may be required. For further information, call MTA NYCT EMPLOYMENT OPERATIONS at (347) 643-7413. Monday-Friday (9:00am - 5:00pm). DOCUMENT TYPE-2 APPOINTMENTName:Today's Date:New Title:Pass No.:Exam No.:List No.:Time Asked to Report:Telephone No.

5 #1:E-mail:Print ClearlyFOR OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE(LAST)(FIRST)(MI)Appointment NoticeCanvass LetterPre- EMPLOYMENT Application Drug ResultsMedical ResultsMotor Vehicle AbstractMotor Vehicle License Form Motor Vechicle Record Release Court Transcript/Record Letter / 5 Year Evaluation PAR /TAMR esumeOffer Letter/Conditional Email Background Questionaire Form Fingerprint RecepitHS Dipl. / College DegreeDP-152/153 (Veterans)DD-214 (Discharge Form)Veterans Disability LetterDP-440 (Vet. Disability Claim)Terms & Conditions (OA/MTA)Deferred SlipDS-10 & DS-12 (Updates A&B)CPD-B (21 Page Booklet)Acknowledgement (New Employee Info. Package)Other _____ Liaison's Initials-------------------------------- ----RECALL - FAIL TO REPORT - VERIFICATION---------------------------- --------First Phone Call Date:Time:Respondent's Name:Response:Initials:2nd Phone Call Date:Time:Respondent's Name:Response:Initials:Date Recall Letter sent : sent By:FTR Human Resources\eForms (Rev.)

6 4/18) PLEASE CHECK ALL DOCUMENT INCLUDED IN PACKAGE ProvisionalTemporary Non-CompetitivePromotionPermanent ReinstatementTAOAS ection 71 Section 73(1) TIME-IN(3) OUT-OF LAB(SIGNATURE REQUIRED)(2) TO LABC hecked By: InterviewerI-9 EMPLOYMENT EligibilityBirth CertificateUS PassportEmployment Authorization CardCitizenship PapersLicense / CDL PermitSocial Security CardFamily Member Disclosure FormEmployee Data Change FormDual EmploymentEmergency Contact FormDOT FormPending FormsRetiree/Vet Form (Pink Sheet)MTA Bus CompanySIR-()Social Security NumberDemotion Human Resources\eForms (REV. 11/00)I UNDERSTAND THAT MY APPOINTMENT OR PROMOTION IS SUBJECT TOSATISFACTORY FINDINGS OF A DRUG :EFFECTIVE DATE:LIST NUMBER:(Signature)DRUG SCREENING NOTIFICATIONName:Date:PRE- EMPLOYMENT APPLICATIONBACKGROUND VERIFICATION QUESTIONNAIRELast Name FirstMITitle of PositionHome Address, Box, Number and Street (Apt.

7 No.)Social Security Number (List other numbers used.) City and StateZip CodeHome Telephone G E N E R A L I N F O R M A T I O NPlease print information in ink. If additional space is needed, attach a separate sheet of SURE ALL QUESTIONS ARE ANSWERED COMPLETELY. E M P L O Y M E N T I N F O R M A T I O NYesNo If No, enter type of visa and/or alien registration number:YesNoAre you a United States Citizen?Are you legally eligible to work in the United States?(Proof of eligibility documentation will be required at the time of hire as required by law.)Page 1 Mo/Yr Mo/YrSupervisor/Telephone:Work HoursPer Week:Start with your present job and work back to the time you left High School including unemployment time.

8 Do not omit any jobs or required information. If you have more jobs than space permits, request additional EMPLOYMENT Information page(s) to list them. Use an EMPLOYMENT section for each time period you were unemployed. Where placed by a temporary EMPLOYMENT agency or union, specify the name, address and telephone number of both the temporary EMPLOYMENT agency or union and the work placements. Indicate those jobs in which you were self-employed by printing "Self-Employed" and the telephone number next to "Supervisor/Telephone". Include any previous NYC Transit, MaBSTOA, SIRTOA, MTA HQ, MTA Bus Company, Long Island Rail Road, Metro-North, Bridges and Tunnel or Capital Construction EMPLOYMENT you may have had at :Work HoursPer Week: Mo/Yr Mo/YrSupervisor/Telephone:Work HoursPer Week: Mo/Yr Mo/YrList other names used, maiden name, nickname, assumed name.

9 List your residence(s) in reverse chronological order most recent first for the past 10 Mo/YrTo Mo/Yr Dates From ToEmployer's Full Name, Address and Zip Code(include department name if applicable)Title of Position Reason For LeavingPresentPage 2 E M P L O Y M E N T I N F O R M A T I O N(continued)Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week: Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Dates From ToEmployer's Full Name, Address and Zip Code(include department name if applicable)Title of PositionReason For LeavingSupervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week:Supervisor/Telephone:Work HoursPer Week.

10 Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr Mo/Yr E M P L O Y M E N T I N F O R M A T I O N (continued) Page 2A Last NameFirstMISocial Security NumberSignatureDateTitle of Position Dates From ToEmployer's Full Name, Address and Zip Code(include department name if applicable)Title of PositionReason For LeavingFederal and or State law prohibits discrimination in hiring and EMPLOYMENT on the basis of race, color, religion, national original, sex age or marital question on this application is intended to secure information used for such Resources\eForms (REV. 07/19)A P P L I C A N T ' S S T A T E M E N TMajor# of CreditsYesNoYesNoYesNo E D U C A T I O N I N F O R M A T I O NMajor# of CreditsMajor# of CreditsM I L I T A R Y I N F O R M A T I O NYesNoYesNo2.