PERSONNEL DATA FORM ‘Texas GENERAL LAND OFFICE Lye Malin Address: state ip Code: Cell Number: | Gender: [Male Female ae See ufie|o4 fs podfe {any ofthe information changes, lease submit completed Persannel Data Change form {found on the "Forms" page ofthe GLO Intranet to Human Resources. Roveed 11/5/2014PuBLIc INFORMATION AcT ‘Texas GENERAL LAND OFFICE “Texas Government Code §552.024 requires each current employee, former employee or official of governmental agency to choose whether to allow public acces to information in the custody ofthe agency ‘that relates to the person’s home address, home telephone number, emergency contact Information, social security number or that reveals whether the person has family members. Ths form must be completed at ‘he tme of hie anc again at se2aration; an employee may at any ime change the option previously selected by completing a new form. Please mark the following as indicated, |ido.not wish to alow public acess to my: 7 | Home Address (This does not protect P. | Home Telephone Socal Security Number Information that reveals whether | have family members / [Emergency Contact infermation ‘Boxes from disclosure.) |1do authorize public access to my: Home Address Home Telephone Social Security Number Information that reveals whether Ihave family members Emergency Contact Information - Vannrder sea} |) - ont yo t ay Revised 6/4/2014(Crime Victim ELECTION ‘Texas GENERAL LAND OFFICE lease check the appropriate box to indicate your election: | elect to allow public access to information held by the Texas General Land Office that woule identify or tend to identify me asa crime victim, including my photograph ‘or any other visual representation of me. (HB 1027, 78th Legislature, RS.) {do not eles to alow public access to Information held by the Texas General Land © | ottice that would identity 0° ten to identity me 2s crime vit, including my photograph or any other visual representation of me. (HB 1027, 7th Legislature, RS.) Employee Signature: Date: Jel Nel Distlosure of your Social Security number (SSN) Is required and authorized under law: 42 U.S.C. '5405(c}(2Ne() and TEX. GOV'T CODE $5403.01, 403.015 and 403.078. The number wil be used for tax, payroll and benefit administration, and identification of any individual affected by the law. State ‘employees can elect in writing to protect thelr SSN from public disclosure undler TEX. GOV'T CODE § 552.004. ah & Ws > Revised 11/5/2004EMERGENCY NOTIFICATION INFORMATION Texas GENERAL LAND OFFICE For your safety this emergency notification information must be included in your personnel fil. | Employee Name: Yor Date: Whe jy JEMERGENCY TEXT NOTIFICATION OpT-IN/OPT-OuT ‘Texas GENERAL LAND OrFice =A]. Optin for Emergency Notification: Purpose: Emergency Text Notifications will allow GLO/VLB to better communicate to staff during ‘emergency situations and relay information relates to but not imited to inclement weather closures, and ‘ther emergencies which would directly impact business and staff 8 opting in, you wil allow TXTSIGNAL, the General Lané Offce/Veterar’s Land Board emergency text notification provider, to cantact you via teat ta receive emergency notifications, Your participation in thie service s completely voluntary and for employee use only. Employee Name: tbe Weta dl Sate CellPhone Number: Program Area Cell Phone Carrer: Signature: = a Date: feds By signing above, |ackrowiedge that | have read the information provided below: ‘The GLO/VLB uses a third party vendor, TXTSIGNAL, who will not share or distribute personal information {gathered by ths form unless required to do so by applicable law and wil use it solely for the purpose of providing emergency notifications and periodic system checks. The GLO/VB wil not assume legal iabilty ‘or responsiility forthe accuracy, completeness, or usefulness of any information provided by submital of this form or the sevice. Its up tothe employee to submit correct and up to date information. Any change in phone number must be updated in order to receive emergency notifications. Text Notifications wil only ‘work on cellular phone devices that possess tenting capabilites. ll charges related to text messaging are the responsibilty ofthe employee, GLO/VLB will not reimburse for charges incured. Standard text messaging rates will apply. You may opt-out at any time by texting STOP to 94033 and by use of this form, (Opt-Out for Emergency Text Notification: 'keowingly nd voluntarily have chosen to opt-out my personal contact information from the General Land Office/Veteran’s Land Board Emergency Notification System. | understand that inthe event ofan ‘emergency, | wll not receive any text notification va my personel cell phone. | may opt-in at any time. Employee Name: Date: Employee Signature: ‘Once completed, please submit to Human Resources Rese 13/5/2014Now Hire Check List Employee Name New Hire Posting INew Hire Letier rsonnel Acton Ferm [state Appication ckground Check Authorzation Sackground Check Atidavt rsonnel Data Record Form HERNANDEZ, John Robert Date attend NHO: sanoro14 snior2014 Now Hire Benefits and Records Forms bata Fore L9 Employee Ey Veficaton Airis reser otteston) “persone Dela Fem “New ret rponyNoicaton oa tor At bal Sevice fret Repaerent Pay Levey Ferm tran Status Veterans Preererce Gutsce Employment Notion [Divers License Check Form & Poley Notary ntrmation Ferm Joe: Depost Ti |sotectve Servic Veriton [Eis Jrormer Foster Chia Foon ‘New Hire Orientation lotice to New Employees Concerring ~JWorkers Compensation in Texas fomputer User Agreement & Comuter unty Policy “Employee Letter Of Acknowledgment —)- Policy Review Ethics, ncucing a copy of Texas Government Case Poltcal Ad and Legislative Infuence 1d Prevention Equal Employment Opportunity ‘Complance ‘Sexual Harassment Drug-Free Workplace HIVIAs in the Workplace |Employee Letter of Acknowledgment \ Tethies Poicy ‘Acknowledgment Forms JEmpioyoe Lotr of Acknowledgment - Benefits and 5s Forms ble Information Act Exceptions - General [Pubic Information Act Exceptions - TDCI Employee Crime Vicim Identicaton Election onfdentalty Agreement Form lEmployee Property Responsibly Statement |Empioyee Acknowiedgment - Automatic 401K [Enrolment ZJOpt Out Crest & Waiver of Insurance Benes Fasurance Multipurpose Form and TexFlex Form ]Employe Letter OF Acknowledgment - Handbook and ethics Ethics Policy ‘Statutes And Rules Governing Ethical Conduct Required Disciosure Of Potential For Conict OF Interest ules Concerning Uso of State Property Protection of Proprietary or Confident Information ‘Statement of Policy ‘Sexual Harassment Fraud Prevention Poly Employment at Wil ‘Standards of Conduct Professionalism in Pubic Service Nepotsm Employee Partcipaion in Agency Programs ‘Soetaton of Denatons t Revised 110772013,‘TEXAS GENERAL LAND OFFICE NEW HIRE PERSONNEL DATA RECORD 11102046 NEW HIRE EMPLOYEE socw secunTy Last nae ee Pf a HERNANDEZ I JOHN La] yo] isPantc sue a [NA__TSENT TO BUDGET.@ cml : ___aktogaramrc om 5 Tas ta wT : Ties ai Romande John (R) — rere Ce cack Tera mney wt mck ip of toe ea] — — —— mo werner Choeentan Damier ‘Oxtinn ir Deine | .Gemechen ronan | Fearn ein Bsenten Hettec fetid Brsmear Irasefommnersae | Bostosies___ | lteter bier eo ste = Beta ic 7 Bos Rinecraener cu | RU seOndy 4cmnse | Cesena) uate | eters rane son Fan Besse sR Domain po Os gs ano a Ge xngarent ene wet ee TH 0 Sica oe al ee Gal ee Ste a= a ar) ae | ae tt tzony [sy Cintra | WmEeonyy | pind tinea Shen Rims | Eine seem : ost Thane TERaiayS [imtecticomy, [amt Om se tneoay) [Eran | pas Bi] actin | cee | | Fy | Saar iat Tie” |e Lane Medes evi tes inanenspeteence cesar seen ‘EEESRE Bp seri snanetager qc tdahipeielotreratio BSS Eo ies te copiers orcroneraatare sean no aa ESSE ii eyes Sens sf arenas ae — = ForPayoll Us: Ua eoy ea — Rew 102014“a ett |acacrs 0100 mw ast Too b0io3002 Goa waRc> 2 WY CHG _DT=> 00/00/0000 NON PAY CHG DT> DO7OO75G00 LOVEE DESCRIPTIVE DATA ~ ALL EMPLOYEES assias pr» 03/01/2015, REASON CD/EXT> 038 (086 cope--—--> o0L03000000 / exEcurIvE, PCA/Bewt> £01030. / 100.0 LOC/ERT> 0000 /CHIEE OF STAEF/IAC gon crs/rrmizes 1622 / 1 mr cann> GRP=-non=> B28 SAL> 10583.33 RATED 00000 HRS/FTE> 40.00 / 1.000 ENP TYE> CRF PAY FREQ/TYEE> M / SALARY FLSA ELIG/EEO CAT> EXEC-EXEMPD / A PREY 08 INACTIVE I> 00/00/0000 CRETE /OPDATE FOS-—> POS TYE> A'REGULAR 20-4 02 BUD UNIT> S24 ‘SPV 708> W296r-z0sTTI0N BFF Dr = 03/01/2018 06/00/25 14:25:08 4 MLL eARTEMPLOYEE HISTORY - NISC CORRECTION 01/2015 20, = szrasya01s 20 = cayoiz2018 20 A205W-END OF LIST 0010300Spe teaten woonmne ses Mareen é HERNANDEZ, JOHN l Reta Cimon foe ~— gs cn deme Bone ines Ditieincane {3 cme neem Tae leet om ata cat Bite vate hy 02/01/2015 +4/1072014 feminist CD iatreme bc Taner inant Coa Solimes™ | 130 om en's being promot Sh of Sa ptnFrom: oyna Prater To: (Conrad Swan; James Duncan; Londa Freeman Date: 91972015 11 58 AM Subject! MSR Update Attachments: 20150609115208556 pot Due tothe rerg, he folowing employee had an MSR change: Jonn Hemandez (was $) now M as of 0101/2018 Please note, | have made the update in USPS on the HMPHR actve screen andlor HNHUE screen and the before and after screens are attached, Please update your systems to maich Ifyou have any {questions please let me know. (cynthia L. Prater Himan Resources Specialist ‘Teras General Land Office ‘Stephen F. Austin Bldg Room 730 (612) 205-8132-0ftee (612) 475-1555-Fax ‘ynthiaiprater@glo texas gov(cov00 as /erE> FLSA ELIG/EEO caT> VE. p> 00/00/0000 LAR eOut>. OL BUD USIT> 5 EEF ox = 03/01/2018 (olalls — Due 4 "Assign 07" being atte Wow PAL CHe pr! Tred bo use a Curent ‘locle. 45 process IHS 0337 Change. The Grange fo msdeM Wad effec avr a Yelle. ° {lever ay i FLSA Review > isl John Herande| [omc Administrators Director ‘Erpoyee Name EO CODE Gaston Tite © Non-Bxempt a 4 Adminitrative Exemet (© primary ty isthe performance offer non-manual work ect rated tothe management er general business operations ofthe employer or te employer's customers; and (© primar ty includes he exes of cretion and independent judgment with respect to mattrs of signee 2 Executive Exempt a (© primary ty s management ofthe enterprise in which the employee is employed or ofa ustomarly recognized {department or ubdion thereat (© euttorary and regularly recs the work of two or more other employees; ad (© asthe author to hire or re athe employes or whose suggestions and recommendations so the Hin, fg, advancement, pomton or any other change of satus of other employees ae even parler weight 2 Professional Exempt Qo {eared professional primary dts the performance of work equing knowledge of an advanced type inal of oence or erring curtomary sequel by peolonges course of speclze intelectual struction (© the empoyee must perform work requiring advanced krowieege; (© the advance knowledge must bn ld f Slane or learning: and (© the advance knowlege must be cstomarlysequired by a prolonged course of spelled intact ‘restive professonai- primary ty the performance of work requiring vention, imagination, ora talent Ina recognized fe of att or reve endeavor (©. primary duty must be the performance of werk equing invention, imagination, ona or talent in 3 Fecognlued fil of arts of creative endeavor 2s oppose to routine mental, manual, mechalcal or psa work and (© the work performed must be “in 2 recognizes ldo arse o creative endeavor.” 4 Computer Exempt a Primary dy eons of . (© The appeation of systems ana techniques and procedures, incang consulting wih users, to determine hardvare, software ar sstem funcional spacieatons; (© The design, development, documentation, ana, eeation, testing ox moification of computer systems of programs, including prototypes, based on and elated 1o user or system design specfeabons . (© The deve, documentation, testing, creation of mediation of computer srosrams related to machine operating systems of (© Acombinaton of he aforementioned utes, the performance of which requires the same evel of sil ae Wig _lusorcailrdeehopfe evo fom doce Revised 1192014PosiTION DESCRIPTION ‘Texas GENERAL LAND OFFICE Emplois Rane [onn emander Foreinal Te ‘#0 Gass. ile: | Drecor Progam es Beatin Supervesrieme! [Lr Lae Dion = ave eretoge= | %_ | NumbarSopeied™| | ot arora Section. Commissone?s Standards of Condit ~Povtedin the GLO Enlavee Handboak | Seaton 2. GENERAL DESCRIPTION = rom the State Auditor's Oe State Job Clsifcaton Descripons Performs vance enor evel) managerial work proving rection and guidance in sateie operations and planning. Work | ves estabishing te stratepi plan an goals and objectives deveoping polices reviewing guidelines, procedures, ‘es, an regulations; eabisingprotties,standards, and measorament tools for determining proses in meting goals; Cecrdinating and evaluating progrem aces and reviewing and approving budgets, Pans, sigs and supervises the “work of ethers. Works under minal supervision, with exten atid or the use of itistive sn indepencent demert. ‘eaten 30 election af "Essential ar "W° ara ie raqurad Ter eaeheb aR) eb Buty 2 1 |] | Pieets roam areas and acres. 2 || Eo] Petonsand imsementstchnigues for evaluating program atts, 3 |o] ca Dette etaines goats nd cbecnes content wt the gee’ satepe lan ||| Peons reviews, and approves budgets 5 || pa tenis tne neat ese program aes Provides rection, gulance, and assistance in program areas). reviewed wy CAA Revised on 10/23/2014Represents the agency at busines meting, Nerings, ti, leltve sessions, conferences, and Seminars eon bears, panel, an commis. Pans, develops, implements, coordinates, monitors, and evalates policies an procedures, Reviews rests of special investigations, internal audits, resenreh sues, forecasts, ard modeling ‘secs to provide ection and guidance. evo eines wari 5 acne ad comes Wi a GLO BENE _RYSICAL REQUIREMENTS -Slect One: [Tis poston eure enor primary peor edenary fice wrk tower, maby nd rd wah) roa ‘Soe tehone angler contact onmumeaten, rere ty tbe, bo, neh $k request ses ering th sya, ‘eens ean prctes ng pes ree the ‘arena to marainateton etal pe eruption Ay | 38 owr pat pray ands arepr eos | thetosttr repre ttne ween commuting arom | feavorkoodwonneesiemens. [a scons reaurae=” _ ee a hs etn recures the alow pinay parr rom Sesenarywork moby (tara nd wake! sous, mbna juin on uneven sacs, ch tain anor {eee sear utes egret yt ben, 09 kee, ‘eae arse’ a tant eed he son ees sooal copie sli reutinghe sity ear recall ‘eqs te aio eed pted mater and compen “and cent/eustomer contact and communication, The indie ‘mat beable ul pal Pond ar targa ese, Aecunen, boxes, ube ad all mati nd ltd ok, {hie to strong ards of ome when onmueng to ana rom scputere abet werk oso sn osat erent ondins oincue Se, ahd enorme orquesions EMPLOYEE- / understand and ogre to the enectotons et ut ond ffrenced m5 or ond have ani led ues those expectation il eecuss tem with my spervaon Employee Signature: 'SUPERVISOR- (Wot Team Leeder) Bae UEcused he expectant 00 ad ference thi fr with he OMBOVSE ond consgered ay feedback ans suggestion. (il ounce! te employes shoud there be ony performers [Senecio irate ate: Printed Name DEPUTY: Rowe ead ad appv he eects Stout and referenced in hi Jom forth move. Deputy Senate fee [ome | PrntedNeme: | tary lane | Tis document does nat onstute te tems ofa contac of employment and should tbe consbued asa guarantee of | continued employment or progressive dscipine A employees of he Texas Genera Land Office serve ot the wil and | leosire of the Teas Land Commisione Reviewed by: CLA Revised on 10/23/2018ante Position DescriPTiON Rec'din HR WS USPS Entry lol; Tana at ‘Texas GENERAL LAND OFFICE pies Name [Rerandes Fanconi recor of ub Aas SHO Css. he: | treo Program Ae ecutive Supervisor Name | George Pah Dison Execute Travel Percentages | 3% | NumberSupentsedi [3 — [Date s/s Section 1. Commisione's Standards of Conduct ~Postedin he GLO Employee Handbook Section 2. GENERAL DESCRIPTION rom the Sate Avctors Of State ob Classification Desrans Performs Way sdvanced (seiortevel managerial work proving recon ana guidance fr the Excutve Ofc and the oie of Communications. Work involves establishing the static pln and goal and objectives; developing ples reviewing | uidetes, procedures, rules, and regulations establishing piers, standarés, and measurement tol for detening progress in meeting gals coordinating and evlusting program atts ndreviewing and approving budgets. Plas, assigns and supers the werk of ethers. Works under minimal supervsan, wth extensive nse forthe use of inate and independent judgment. Seaion 3. 308 DUTIES ~ Noe The seein of°© zen or“ (arg w requred for eachob iy “ob uty | € | M : Directs Execute Ofce and oie of Communications program areas and ates. 1 [alo 2 | 6] Ca Dxveors and implements technaues for evlating program acts. Develops and establishes goss and objectives consistent with he ager’ sate plan 3 | 6a) cy Sevlons and estates goals nd ob ith he agency strate pl Develops, revews, nd approves budgets | Deen poroves bude 5 | BY) | Monsies the need to revise program areal | Provides direction, guidance, and assistance in program areas. Reviewed by:-44A- Revised on 10/23/2014Pans, develop, implements, cordnats, monitors, nd evaluates pois and procedures, > | 5a | C1] Pars devon. lem co Pe s jojo ojo “0c | — | Parone eats worn assigned ond complies wih a GIO poe ‘YSICAT REQUIREMENTS Select One: 'STANOARD DESKIO8 | i} “STANOARD FED 108 | a. Ths potion requesthe eloye to pina pero dey ‘ce worshowever most fang an wah rowel Compser, eghone acerca est ond ‘onmantatn,ireqies the abit to bend oop nel and Teach esdeé for fingan sl rt see des Thelob ho requre ema eaptve abies equine sty ten, "ec and ppy ean patie and ails eguces the ‘oma main oteton deta eres Alty ‘edb pl psa bande, od onspor records ‘heuer rete nfomaton ana atei, ‘tig op to 20 pouns when requ. The rl mst be ietostr long pard of me when conetag to atom | Seemed drerason anawhen veg on slate buses cing ‘etiork and waning asigmen “Th tn reaurerhe oye pty parm nom cerry wore maby Sanding nd wang) rot ‘tured toca out me sues ecg nese wang Clnting nung on uneven voces, rough eran nar ‘ote areas Dts require he sty to be soo, ne Teochandorstee a ost st ete. The poston eqaes al og sities aging the siya, recal ané onl certain rcs a poles. reqs he sama to ‘rutin ateton fo tal dep serps Ts poston ‘jar he aby tread re ater comer ‘Ser: Te poston may requ entre comput, twephone ‘ra clenvstome ont ad conan The ne ‘mut be abi toi pl pysealy hand, and anspor record, ‘documents boxes eure ada materials andl to ‘sng upto 30 pounds when equ. The inval mus be histo strong pes of tne when conmutngto anon ‘sgnedGetnaton and when tosng on sate sess Inc eur sarin seen Ts poston ‘euch aby fo work ote and adapt to overs weather rosa inde a, ky ond endronon “hy atonal requirements {MOVE nderiond od pe ean ot on renee sm a ae HT them wih my pen, ihe expectations et ot and referenced in ts fom with he emporee ‘and considered oy wi counsel the employee should tere be any performance concerns. Supervisor Snature: ate i Printed Name: IA DEPUTY: Rowe ead angGpprove td expaotiond st od referenced in tor for this employe. Deputy Signature: ate Pinta Name ores PB ¥ leaaure ofthe eros tnd Commissioner. : Reviewed by: C4 This document doesnot conse the terms ofa cantar of employment and soul ot be constved so guarantee of Continued employment or progresive diplne. All employees ofthe Texos General and Ofisserve tthe wl ad Rese on 10/25/2014com [_—— 298) oto | (01/01/2017 1/10/2014 sinter in (Scr cage FF ene) (lhe ana Ti oo Eibteinsee — be Retreat tu se ony CH z Abt (acca Ore te nee poeeenrennen ee | as ny Uae On) (ade ON) {dpe se Ons) ae TT Rai apa - Bi ravtie | veer orice BI] Pectin Q| Ew [eee ese?) 0) | Tema | Serr TF — B [rota | ceonae ous Beet ais 3s done ar cueanding[s8 Tanaping and ovPrseeng fe Corrricaons ans Exec ofices owt the Gast Fea fared Carers or rat haya poeta ere eer on ana ‘cling arta guaance wth epards © GLO presume MW. Reraner oxo leg nae eves evry succestl Sen cle Vr erat feravoroe ee ae land vonigs oe varus erin thy a cari 90 tie Hare (aay etnall aA tfions Pe et pSiows me (GP Rin (Pacefom enon: rnscosnr cron lane e om a Bw Re | HERNANDEZ, JOHN R._ aniz018 11/10/2014 Claverton tenon (Glens freon ae Blomtineicsggzmar | Ota witty Flier mate mene Ein | aoc "Nev Postion Desripion as beached Rate Docume” polite nth Elo Huadiock ov he ara iaacomereet cee oe ceeanees Goer | SaaS [AE [cant Te | a Re TPF ] tintseony tuntac ayy |e ae Ont) Thetseousy tu ea tte ay ‘ete Oa (adges eon (acy oc Ony | ata PD 1 Riri | eam Fy revtime | ERESuTWE OFFICE BA] rete | en Se, Bae] | Fey | ENT Fine Z| hepa ofonoe p_ oust eH i far Harare nes dno nt utanaig ab manogrg ars ove te Canmuncaions anc Enea cies err epost Yea Hea rsd Gerrans oe seat woe yes eo tee rar etre ans ‘Seeking aasistance or guidance wth regards fn GLO programs. Mr Hemnende alsa helped glen and eversae the communications bouan wthin fe sgoncy, Rela siczshl conmuncaten carta Vint Ao, Conran Severs nd Bertizsion. ches ara Record snd fare Manaparent ke odurne hae to eeu eis sane eae aware fd take anvriaje af ne aroue progr win the Guara Cand ees orale progrewsor Cnsopor: Fkasmc careaace eco (Gy) esas General Land Office Personnel Action Form \ oo Hemandez,John RR e | ee 92 ova For merivone inert ations atch eny ofthe erent EPE 14/10/2014 ———— Se —a r sven oe sree Daa nee One Berean Bests agree | Een ny chan Warkaine | E)-bemioe ns ati Te | Gest sows | Bowtie Bist Fore _ {oer expan jy Beimcescererersesmes | ena ea a a a jowoe Handboak on intranet conemeen Oe oe Vining fae a A ow Pepa Doce of ab te Fey Ta cen [ome [FTE] Come Ser | Meaty nae [TE Frade az | sioaarst 1.0 _ | Travis sae | stizetes | 10 Aggro [fegweromy [Ete feyertrton | Eerste ‘Fe Herendez Fat Son a Staring so agg ad ofoionng the Cenmurialats sod Esecuveofces oe the past Vom Hens omuteda te Conmuncatone Ofesstepealy wos wi vrei prota afeas oe a a missonsard Deal otha SL under ne Bush ar aperoaraal nghighaain hemes and ocala cg mince ooudatee wth rear lo GL progiars aleaassho hoo to ensure Texan czas [Ste aivantage ote vareue programs tin the Gensel Lane Oe ots & oars Ramsar tole IR Ta Oui Treo pis pb baal = [Ge lin | CRarsaer P=e e Driver's License CHECK ‘Texas GENERAL LAND OFFICE In accordance with GLO’s Fleet Management Policy, the GLO will coordinate with DPS and review the driving records of prospective and current employees, who may drive to conduct GLO business, License checks for current employees will be conducted at least once a year, or atthe request of the deputy ofthe program area. Driving privileges for operation of agency vehicles will be suspended if the employee does not have a valid (Le, not expired, suspended or revoked) Texas rivng license. NOTE: I your diving «category level as listed below is four, you only need to enter your name & date on the form and return to Human Resources, Room 730, Please select one of the following: TalaL one? Employees who normally drive routinely to conduct GLO business (eg, field inspections, ol spl response efforts, appraisals, warehouse activites) in agency-owned, rented, leased, and/or personal vehicles. ‘Level Two: Employees who normally drive at least twice a month to conduct GLO business, 7 _| Inciucing attendance at meetings, seminars, or workshops n agency-owned, rented, leased, and/or personal vehicles. ‘Level Three: Employees who drive infrequently (normallyless than twice a month) to conduct GLO business in agency-owned, rented, leased, and/or personal vehicles. ‘Level Four, Employees who do not crive an agency-owned, rented, leased, and/or personal ‘vehicle on agency business. Employees who drive on agency business must adhere to the guidelines in the Driver License Check and Fleet Management policies inthe Employee Handbook, such as complying with license ard Insurance requirements and with state laws regarding vehicle operation, maintaining 2 valid Texas chver license, Level One and Two drivers must also attend a defensive driving course every three years. ‘authorize the General Land Office to obtain my driving record information from DPS. FullName: lol sa inden bates [fof Driver License Number: state] D8: SS ee Please mail or hand cary, the completed form, along with a photocopy ofboth sides of your Driver license to Human Resources, Room 730, Revised 11/5/2016e e BACKGROUND CHECK DISPOSAL AFFIDAVIT “ARFIDAVIT: Osvaldo Osio, being duly sworn, herby deposes and says: 1) Insccordance with the Texas General Land Otis Employee Handbook, Policies and Procedures, a criminal background check was performed on the following employment candidate using the folowing background check service: John Hernandez Intellicorp ‘Candidate Background check service 1132014 Date(s) background check performed 2) Based on a review of the background information obtained in accordance with Texas General Land Office Employee Handbook, Policies and Procedures and Federal Trade Commission regulations, the following determination was made: aL the canisete wes cle forhire OR ‘Te candidate was disqualified frre. ‘Attach any letters sent tothe candidate pursuant tothe Federal Trade Commission regulations ‘without any accompanying background check report.) 3) Pursuant tothe Federal Trade Commission Disposal Of Consumer Report Information And Records Act 16 CFR. $682.3 (2005) and Texas Government Code §411.1405, Tex. Gov't Cove ANN. §411.1405, the information included inthe eriminal background check was disposed on the following date by means of cross-cut shredding on_V/f¥. (date of disposal. 1 declare under penalty of perjury that the foregoing information is true and correct. STATE OF TEXAS COUNTY OF TRAVIS SWORN TO and SUBSCRIBED to by paren: __//t¢[eup Human Resources, Texas General Land Office (signature) Upeagfit oan Fabia ae Sak of Teas Rosemary |e jes rinted Name of Nouy :Background Check Authorization Texas General Land Office + Jerry Patterson + Commissioner ‘TO WHOM IT MAY CONCERN: [understand and agree that when being considered forthe postion for Which Iam applying, the Texas General Land Office may conduct an investigation of and obtain criminal eanvietion history, if any, in connection with my application for employment or a voluntees/contract position with the agency. (Such a check will be conducted forall selected candidates.) I understand and agree that such information may be obtained from a public reconds collection service, a cour, or from any Taw enforcement agency including a police department, sheriff's department, or state department of public saety [also understand and agree that if selected for this position, my selection for this postion is contingent upon the results ofthe criminal conviction records check and that I may be denied employment ora voluntees/contact postion \with the Texas General Land Office based on information received as part ofthis records check. This authorization will become part of mv ersonnel or volunteer/contract file, and will, for the duration of mv ‘employment or volunteer/contract position, serve to authorize future records checks deemed necessary BY agency management. [authorize the General Land Office to conduet a eriminal conviction records check as explained above Printed Name Signature Social Security Number Driver's License Number ‘This form must be completed by all applicants who are interviewed fora position with the Texas General Land Office, Completed forms must be submitted to Human Resources as part ofthe hiring packet or volunteer records,ee nesmeoreus . Se APPLICATION FOR EMPLOYMENT — {=== i SRNTMAUCKINCOR TE Tene cen eae ed cy. Fa ppaton om ng. Houta Re ean aeeton tint, rare agrner onesie Tes umm Eas omermy Tye nds act sta Sor aor a Spe Can newport oe onal dsr Ye aya ope of loo fe oars Ds eae a tbe aed Watmcuao bn sopta ne Sonestone ks pcseay Set oe fo asncy ae he ee EoNS pated wa tanceancrs Mas mnietew Sora even asso taps aut hee acy cone crn ate oared PS eed into Cnn SS aor See ts) AYE Homandse on be aun acoress ra itr abe or aeons IR LRN RTT AERTS [Sa sain i YU] OS aa ay WRG TPS Seerl Land oftce 7 Taine Erect Javane CD enphoea oa mtmetraon? TTTQQOT asa Wana Vn NoCD eyo ig wor a ae un 56 Ne st ooo you neo? NA een A Spree pnce De speake tm ctynes peace resin) Stto mnt ci ny nce aren aay are a Na fa ‘Sean ay Sly obra he sane wt Nate Some te pees a. "eu mater oreain te a orcans EDUCATION FTE Apis nay 8 STO FOSS HOT OGOTH TAROT RGR ONS FTE) an Sod Sinn FED? es NOC] yarn dat igh seo or GED tw, Amecan School Foundation: Me oe senegytactn [eT — came | cecae | Se” | aime 2 avr Universi Was [os [os [12 [08 [0 Bachaor [Polticl S I{AN EQUAL OPPORTUNITY EMPLOYER teeter naan ein in ost tin ou gpg come anion baw | ae See ees eansusna cece) | wea | capes | [Se arabersunatty (cys Sut) eos, Steet puma: te angst gone mri crt th ‘eda Tidining- Saat Campaigns. Baiical _ ‘Consulting, Media Relations, Communiestons,Polleal Paling, Gls Communicators, Messanig, Speech Wel -SStes Pon Bulle Spey Motvatena Pobie Sato Boets Mop: US: Mans Rosana 60% bing — glean ani Trasaton, Cour irtrpratg' = ngs Span ernsoy howe wre perma coyeu pe? 7 Sep Lege tie or enn) 48 NOD rey cd pte? Ys NOE 200 Gaon lage hrm Ea rd isi) Whence fu sao Ho hot? Fr Got Extn So yousaein aoa er nae eet) Yee ND ee ocr ergo SSSR 7 te youerrbon apy he St Tee? oo No yay arg neo Tame Yes No you een pee engjety he Sl of Tas, ete genyapeoe: FORMER FOSTER YOUTH (enzaton yb aba) ‘see or ot ph Ts Dap any nd Prac Sanco he ey eae you 1° ey? Yor NeC ene ou sey Sees gn mo? eae ray SERVICE Ac ota tsar Amt Senne maybe eg) Ayu avon? ee) No BL em tt pete eee Ae you scum see ton en rttmarecYox(3No | eyovasewingcrtan wean Yee No ry, compa ese tea ‘PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND NOIGATE YOUR 1 tatters rte emanate wane meme eee ee ere me iseratisreeaeesereneraerene er Sears ae et ean teranctrmanmmee Seale eeaace reams arte Seeceeiaereatee ere Ree ay canermemnary Eee eae Sey eae rg a Se eg ee Reape mnebatoes TwearrucamonmsreescieD soHHERE: ae auf e e EMPLOYMENT HISTORY ‘Tic nfomaton wb he fei cod of your ampoymatt ty and mst cert! ghettos ‘Suara of experence sous clay cestbo Yur asta “lag lL coloymen, Bein ih you cutent rat olin and wn eck ou tt. Elon oy shod ince ntpLOver soonesses must BE COMPLETE MAILNG ADDRESSES, INCLUDING 2>P CODE. fname al unto and capa uma our exparens nena ema and meg Teponsiles ac ay sre ‘ahing, land gutters or eac paton you hare ela Ifyou ned ana epee to scocustty dese your ployment slo, you mays tis spoymentiiry shea er atach a ‘yped employment non arovlng ho same hfmaion fe sara fora a hs appcaton coe os ae ee == ia fer Eee ed ey ee Se war Bene = 4 — Fe, [eee ERT a A TA GORATH SOS TE ‘Communications Doctor or George ® Bush campaign for Texas Land Commasoner Mesa Relations Masia Taming Messaging erence ‘Travel with Condesa Logistics, ‘Surgate Speeking ‘pooch Wirt Trarslation of Campaign Material (Spanish) Graseroots Organng aT rea aa Ta Rr Soren mae mee A eee te See” Ene fete eer Meter Nac ome apo: si Sag bee [Langa Oo] oT =! Sree BeTSSTe Tee [rmsen [eseemy fiapmaarsasewomerar fens pseer [oem [Eee "Sarena Toy So TEAST GATTSANES Fe aT TAR OT | Ettor'n Chl or etstnos com | rt of Facebook Page: Prout Ltnce (lon Les) | Grotr of Facebooe Page Jesus Salve (570% Les) ‘Sonn ona Prot Manager overtaing ‘Greate Director Statooe Advior Dita! Seeteey sectreton ev Suecestl Complaton of Project |Fae oe = aa [eT ning Rca same Sita fomeosa Eyer oeonore No: (_) pects: | Soe ea 1 See a efor Pow ee [ems [tomnans [rpc area om oe ocwmiaeoe 1 [neraon, Sn Span FS HT SSHRC YN aN SAN TSB Press and esa inion Host Training Mesa Workshops Pubic Relations ‘Seminars international Carcate Teiing Peteona Mesesging and Branding Image Consulting ise Management or Corporate and Potl Events and Workshop Management ‘Gommunieston State |Graseroots Pte! Outreach Social and Eleevone Media Messaging Proje Manager Funeral Fundrateng Workshops fEmacyer Set Eretyed Ener oepore ne: F ae oH i tee late [tomes hie Kcr EL ze ngs cal a TES os as de Pres TSE "The Series conto of sx"State ofthe Worle Adresses" gWven by lcballadars who have serve or ao sil arving ‘Media Coorsnatr and Liaison The Henerable Viento Fox: Pesint of Meio (2000-2006); Media Coarsnstr and Usison The Honorable Jean Chrten: Prime Minister of Canase (19962000), -Meci Cooler and Lisson t9 The Henorabe aro Unite Velez: Prose of Colombia (2002-201); -Mecia Cootinle and Lisson to The Honorable Olusegun Obasanjo: President of Need (1999-2007) -Mecia Coointe nd Lisson to The Honorable José Lls Rodigue2 Zapatto: rime Minster of Spain (2004-2012) Coordination of ital Funding for Presidential Series Proeseds benef stucensin Texas nd Moxco trough scholarships, eductonl and social programs administered Souci natn ar evng: Suocesstl Completion of ProjactNOTARY INFORMATION “Texas GENERAL LAND OFFICE Employee Name: NE UE Date of whe |r Program Area: Exec “Are you an interagency transfer (you had no break inservice from your previous state agency)? Ye oe No Were you employed ata state agency while being a notary? Yes x No ‘Agency Name: ‘Are you curently a notary in which you paid for your commission and bond? Yes x No ‘Were you a notary at your previous state agency i which your commission and bond were paid for by the tat (you would have returned your stamn/seal upon exiting)? Yes me No ww ‘TAHR\FORMS & TEMPLATES\NHO\17_hr_notaryinformation,docx feised 11/5/2016OuTsiDE EMPLOYMENT AND RESTRICTION NOTIFICATION ‘Texas GENERAL LAND OFFICE SECTION|—To be complete by employee/appcant Names Ft! [ecncades, Val. perma | E Clssifeation Tile: |= Employee Status: - ‘Desribe what your Gties forthe GLO are for willbe ‘Do you curently work for pay outside of the Texas General Land Office? 7 Yves | [No ‘re you planning to engage in outside employment fr pay within the net twelve months a la wine working at the Texas General Land Ofice? 2 Ifyou ae sel-employed under a corporate or assumed name, or have accepted ar plan to accept other outside employment, less include employer's name and business address. O Tre. ‘eserbe te tur ofthe mpayers bushels and | Number cfVoursper —[Daysand hours you wile Your des for that employe” tweak that you wit wots _| wetting inow [Volz ent Consol Bun FS bnwrs | Sabir deyy t Sendn Ifyou ae subject toa norcompeteagreemitor a sina agreement that in any way limits or estes the work you ‘may do for an employer please describe the deta, ployee Cini herby ert yds nconnetn with the ousisemplopmnt or agreement escibed above fay wl ot cof wth or Inking ony Gates wr reenter the Teas Graal an fst uns th be crests teed on thao hangs, ave ty torent tm a tat rs vse my Desay Conmsoner wring bere accept ay her use emploment "rer ery hat ave red te Stancard of Condit nd Dose forthe eras General a ofan am aware thar may const with the gency aga ON Rave ay quetns concerning those standerds became sear of ty act whch igh nd any pron beve that night hve cone of ares oo uetn te nepener ot trvhegmanin th performance of my dues forte Yrs Geer tnd Ofte, |wil prompt sds my Cen cameo’ of hs fc away ‘Allofthe statementsmad herein are rand correct othe bet of my owed. | seme [pal ate: | [ish EOWA Willemployed's ue’ and/or ttre oasie employmgn cont wih agency polo? ve | Fr Deputy Commissioner Signature: D) Ze bates | iyishy SECON Tobe conte by TB Wilemployee's unt and/or fare ose iloyment confit wt agency poo? ver [Te egal Don Sartre: Mee one fa /i gd Th er Genr od Orla ad i eit ie Ts aap oe ertatan ordain emolyment oe prowon of series The plane number fr the tecommuneaton eve for he hearing Imporedi02) 4635320, evsed 13/5/2014VETERAN STATUS ‘Texas GENERAL LAND OFFICE Secton! Avetrenisdefined as an ndvdual who served inthe Army, Nan, A Force, Marne Corps, Coast Guard ofthe United Stated orn an auiar sence of one of thre branches ‘Are youa veteran? Yes No ‘Are you currently in a Reserve Unit of any branch ofthe Armed Forces? Yes No Ife, which branch? ‘Act Senate Bill 646/Chapter 657, Government Code if || ttepesent and you were dshonaaby shag + you are an orphan ora veteran. "You may be entitled to veterans employment preference as established in the Veterans Employment Preference ‘you served inthe armed forees for at east 90 consecutive days during 2 national emergency from 1933 * you served les than 30 consecutive day and were discharged due toa service-connected dsabilty; you are an individual classified as a surviving spouse ofa veteran and you have not remarried OR |1do not qualify for Veterans Employment Preference. Section I- you quay for Veterans Employment Preference, complete Secon I below in is entiety. Date cele | [ate of charge | (cosy rade arin for nly one galing Sod] Tae thebanchin which you serve Pcl Serviens: ent) Wereyou honorably charged? a] |e you sewed ean 9 consectve ds were you dichargsd witha con ie _service-connected disability? Serving Seu fare yonpo.s ofa vtra who was Ed while on ace Gay andt a remaried? ‘Veterans Name: | [Veterans SSN: "Submit copy of mariage rat and DD 100 oF death erat of een orn Was one of our paren a veteran who wailed on ace dt? me] [ne If so, were you subsequently legally adopted? Yes No veterans ame Veerane SN Submit copy of your aia and DD 1300 death caries of veteran ES ate Whe [4 Signature: bees = ode a aye fevies 18701PRIOR STATE SERVICE TexAS GENERAL LAND OFFICE Ten Vn. Wena DUAL senvice, ‘Are youcurenty employed at ary other stat agency ves | x [Ne {fs0, name of other agency: ‘PRIOR STATE SERVICE Inorder to give you credit for your state employment Texas State agencies and/or State Universities you have worked for and the dates your employment. prior to the General Land Offic, please list below the (or spproximate dates) of Ifyou worked under a different name, please list. ‘Are you a direct transfer from ather state agency: ves ‘Name of Agency/State University: Dates of Employment: Address: Revised 11/5/2014Alicia Villada-Avellaneda - Prior State Service From: ‘lca Viada- Avellaneda To: Hernandez, 1R Date 11/18/2014 1157 AM Subject: Pir State Service ‘Attachments: 20141118114717235 pet WR Page 1 of | ‘A review of your Pir State Service form indicates that you do not have any prior state service. Because the amount of your state service credit deterines yout compensation (such as bene replacement pay anc Tongerty pay) ancl leave accral rates, the accuracy of ths information important. you fins any ciecepancies relating to your state service ret plese contoct Muman Resources as Soon as porsible to reso the discrepancy If comections need to be made, HR il ned to receive 3 new verfiation from that employer to replace the current record Please contact mei you have any questions. Thankyou, ‘lca Vilads- Avene Benefits Records Coordinator Human Resources “Teras General Land office eect number: 512/463-7030 fax number: 512/475-1555 mal lis. vilacs-aveaneda@aloteces.cov file//CyUsers/A Villada/AppDataLo Temnp/XPerpwise!S46B342BDOMIPO_Eight0. ryisao.4JR Hernandez ‘completed Diversity, EEO, and Discrimination Prevention offered by Texas Workforce Commission Training and Development 10/27/2016Employee Letter of Acknowledgment 2016 By my signature on this form, I acknowledge the following: 1, Tunderstand where the General Land Office (GLO) Employee Handbook is maintained on the GLO Intranet, and Tknow how to access and use the GLO Employee Handbook; 2. Thave access and epportunty to refer to the GLO Employee Handbook as needed; 3. understand tha the GLO Employee Handbook contains the policies and procedures of the GLO; 4. Tunderstand thatthe GLO Employee Handbook will change from time to time, that I will bbe notified ofthese changes by email, and that these changes will take effect when posted ‘onthe Intranet and will supercede prior versions; ‘5. agree to follow ard comply with the content of the GLO Employee Handbook, including its updates and changes; 6. In particular, I acknowledge and verify that lam aware ofthe following polices, Lam familar with and understand the requirements ofthese policies, and I agree to follow and ‘comply with their content: > Standards of Conduet > Sexual Harassment > GLO Ethics Policy > Required Diselosure OF Potential > Fraud Prevention Policy For Confit OF interest > Professionals in Public Service > Protection of Proprietary or > Nepotism ‘Confidential Information } Rules Concerning Use of State Property > Employee Participation in Agency > Political Actives Programs > Statutes And Rules Governing Ethical Solicitation of Donations Conduct 5 Acceptable Computer Use Policy > Employment a: Will > Statement of Policy 7. All employees of the Texas General Land Offic serve at the will and pleasure of the Texas Land Commissioner. Employment may be terminated at any time (with or without ‘cause and with or without notice) by either the employee or the Texas General Land Office for no reascn or for any reason not expressly probibited by law. Any written or ‘oral statement to the contrary by a supervisor, or any'other employee or representative of the agency, is invalid and should not be relied upon. The Employee Handbook does not constiute the terms of an express or implied employment agrooment and docs not create any property right in employment or a guarantee af continued employment or progressive diseipline {understand hat tis Leter of Acknowledgment will become prt of my personnel ie Nie eee Employee Name (please print) apo ls imployee Aigydture Dateacu Erp 0 0450 4508 DANO FESAUSEZDEC Training Verification MANDATORY: Ethies Trining Trainer(s): Julie Masek Taped on: March 25,2015 ‘By my signature on this form, I acknowledge and verify that I attended the above referenced training in it entirety (1 hour). | understand that this Letter of Verification will become part of my personnel file 3.8. Hernandez Frnployee Name (pin) ( seh 5/19/2015 ute DateCONFIDENTIALITY AGREEMENT ‘Texas GENERAL LAND OFFICE KNOW BY ALL THESE PRESENT that |, Joln~ \ervuind e2 , a6 condition to my employment. with the Texas General Land Office (the "Agency", have and do hereby agree to the following terms and conditions concerning the confidentiality of certain information belonging to and/or generated by the Agency. That all computer programs and designs, formats, procedures, reports training materials, and other data generated or developed in the performance of my duties for the Agency; as wells all confidential or proprietary information including but not limited ta information regarding pending or contemplated litigation, privileged attomey/clent communications, policy deliberations, confidential personnel seologcal or geophysical Information, aud working papers, Texas State Veterans Homes resident and/or applicant information Information, pending or contemplated realestate sales, leases, or exchanges, Including but not imited to personal financial/asst information and privileged medical information, Information relating to TSVH private operators andor subcontractors; or any other computer or non- computer materials or Information as may now exlst or might be created during my employment with the ‘Agency by me while an employee ofthe Agency or by others during their employment with the Agency is the sole property of the Agency and of no one else. “That | further agree tha: during my course of employment | will maintain, tothe best of my ability, the protection of such confidertial and proprietary materials and information from others outside the ‘agency, the items included inthe definition above, and use my best efforts to prevent unauthorized lisclosure or use of such Information, computer or non-computer in nature, as an ongoing condition of my That have entered into this agreementas of “> Dood while employed with the Agency and I realize thatthe Agency s relying upon it and the pledges contained herein to its trent. signed on this neo dayof_Nevew wer, 221% year. ‘employment, RW isla siaada eae! \. cu. Resed 11/5/2014EMPLOYEE PROPERTY RESPONSIBILITY STATEMENT ‘Texas GeneRaL LAND OFFICE Employees of the Texas General Land Ofice are liable for property loss under §403.275 of the Texas Government Code, which states that a person I lable fr the loss sustained by the state If (1) agency property disappears, asa result ofthe falure of the employee entrusted with the property to exercise reasonable cae fr its safekeeping; (2) agency property deteriorates as a result of the fllure ofthe employee entrusted with the property to exercise reasonable care to maintain and service the property, of (3) agency property is damaged or destroyed as result ofan intentional wrongful act or of 3 negligent act of any state employee, ach person who contrbutes tothe loss may be held responsible for allo par of the dollar value of the loss, | have read the above statement ancl accept fll responsibilty for the safekeeping of agency property in accordance with this statement and Texas Government Code 403.275, apes \. 2. BS ole ly Employee Signature: ve Ih = ‘TAHRWFORMS & TEMPLATESINHOUO_hr employeepropertyresponsibility.docx Revised 11/5/2014‘CompuTER USER AGREEMENT ‘Texas GENERAL LAND OrFice print name)_ Yoh Lkemande 2 have recived, rea¢ and understand the ‘Texas General Land Office and Texas Veterans Land Board (TGLO/TVLB) Computer Security Handbook and the TGLO/TVLB Acceptable Computer Use Policy |Lunderstand that state-ownec computer hardware may be used only for oficial state purposes. agree to abide by US. copyright laws pertaining to computer software. | understand that proving urauthorzed computer accesso anther party eg by dlosng a password or ter Keaton, wy rng data who authotzao,or wf caing computer matron ates ths agreement. | | understand and agree that | have no claim of privacy for any communications created by me or received bby me on any computer equipment owned or operated bythe GLO, and that these communications are subjectt inspection at any tine, | understand and agree that il violate any ofthe provsions referred to inthis statement or in the GLO | ‘Acceptable Computer Use Polcy, may be subject to personal liability and/or disciplinary action up to and. Including termination Empoye Signature 7 / 'L ore Lufiedit Ta : Revised 11/5/2014Pouicy ACKNOWLEDGEMENT ‘Texas GENERAL LAND OFFICE By mi signature on this form, lacknowledge I have received materials and training covering the following. ‘subjects and that | understand nd agreed to comply withthe provisions inthe GLO Employee Handbook ‘on these toples: Employee | AR Initials | initias le, ncluding receiving cope ofthe GIO * this Policy (1-08), Gov. Code Subchapter Sections 572.051:572.061, 60 statutes and RulesGovering Ethical Conduct policy, {60 Required Disclosur of Potential for Confit of interest poly, . Penal Code, Sections 3602, and 36.03 (re: Bribery and Coercion of Public yo wh Servant or Voter + G10 Rules Concerning Use of State Property poy, + Protection of Proprietary or Confidential information pole, and + Penal Code, Sections 3802, and 3.06 (e: Abuse of Ofc Capacty and information. Police ld and Legislative Influence including receiving 3 copy ofthe GLO < Political Atvties pole and copies of Texas Government Code Sections 556.004. | 4 <" 556.005, $56,006, 556.007, and 556.008 Fraud Prevention, including ecelving a copy ofthe GLO Fraud Prevention pliey. [Yo | Equal Employment Opportunty Compliance, including receiving copy ofthe GLO escent roy ea |e ieee ncaa RNR aero NE Re TR policy ae ene ye ‘Drug Free Workplace, including receiving a copy of the GLO Drug-Free Workplace ae b we ‘HIV/AIDS in the Workplace, ircluding receiving a copy of the GLO AIDS/HIV in the ye ‘Workplace policy and the Texas Department of State Health Services education aN panpue on h/AbS me ge ‘understand that ths Letter fAcknowledrement wl become prt of my personnel le Employee Name: | Solan ernun dee Date: wie Po imme) a dfe ZE\ZZlele é evsed 9/15/2014EtHIcs ACKNOWLEDGEMENT ‘Texas GENERAL LAND OFFICE ‘By my signature on tis form, lacknowledge that | received copies ofthe GLO Ethics Policy and Subchapter |] Cof Chapter 572 of the Texas Government Code {sections 572.051 through $72.061) on the date indicated below. | understand that this Letter of Acknowledgement will Become part of my personne le. Employee Nam Yawne der pate: | who Va a evsed 11/5/2014HANDBOOK ACKNOWLEDGEMENT ‘Texas GENERAL LAND OFFICE ‘By my signature on this form, facknowledge the following: understand where the Genera Land Office (GLO) Employee Handbook is maintained on the GLO intranet, and | know how to access and use the GLO Employee Handbook [Ihave access and opportunity to refer to the GLO Employee Handbook as needed [understand thatthe GLO Employee Handbook contains the policies and procedures ofthe GLO | Tunderstand thatthe GLO Employee Handbook will change from time tote, that | willbe notified of ‘these changes by email, and thet these changes will ake effect when posted on the Intranet and wil | supercede prior versions. {agree to follow and comply with the eantent of the GLO Employee Handbook, Including Its updates and changes. In particular, 'acknowledge ane verify that | am aware of the folowing policies, ram familar with and Understand the requirements of these policies, and |agre to follow and comply with thelr content: ‘Standards of Conduct <~_| Employment at Will a aS [Sealine esa Dacre TFS COE | rr Prevention Fey pee Polson nub een 7 | Petecnt pita or Goniteiat | Nepotism | Employee Participation in Agency Programs Rules Concerning Use of State Froperty ~~ _| Solicitation of Donations = Political Activities /_| Acceptable Computer Use Policy - ‘Statutes And Rules Governing Ethical o sas stent Py All employees ofthe Texas General Land Office serve atthe wil and pleasure of the Texas Land Commissioner. Employment may be terminated a anytime (with or without cause and with or without notice) by either the employee or the Texas General Land Office for no reason or for any eason not ‘expressly prohibited by law, Any written or oral statement to the contrary by a supervisor, or any other employee or representative of the agency, i invalid and should nat be relied upon. The Employee Handbook does not constitute the terms ofan express or implied employment agreement and does not create any property right in emsloyment or @ guarantee of continued employment or progressive discipline. | understand that this Letter of Acknowledgment will become part of my personnel le. Eiereenant Jen emer dez ates | Jlofay Employee Signature: Revised 14/5/2016Employee LeTrer OF ACKNOWLEDGMENT ‘TexAS GENERAL LAND OrFice "Thereby acknowledge receipt and completion ofthe following: A | ethics Acknowledgment Z| Outside Employment Notification * Z| Handbook Acknowledgment 7 | Drivers License Check 7 (| Policy Acknowledgment 7 | rior tate Service 7 | Public information Act 7 | notary Information 7] crime Vietim Election Workers’ Compensation Notice ~| Personnel Data Form Workers’ Compensation Acknowledgment Emergency Notifiatior Information | opt-out credit & Waiver of insur. Benefits Veteran status ‘Automatic 402K Enrollment | Former Faster child Sttue 7 | computer User Agreement Confidentiality Agreement 7 emergency Text Notifieation Opt in/Opt-Out Employee Property Responsibility Statement | “| Employee Letter of Acknowledgment 7 | penefit Replacement Pay ‘nereby acknowledge receipt ofthe following: 3 | RS: Benefit Election [wa TexflexEnrllment/change /] Direct Deposit authortation / | Dependent child Certitcation (if applicable) understand thet this document wi ‘Contact Human Resources if you would lke copies scone par of my oficial personnel records, of any ofthe documents you completed and turned in to Human Resoures. Meu Employee Name: dew Employee Signature: Date: Whe Jas eae 1105/2014