Exhibit H-3 SF 85P .pdf

This is Standard Form 85P, "Questionnaire for Public Trust Positions," which is used by the U.S. Government to conduct background investigations for applicants or incumbents being considered for public trust or sensitive positions. The 11-page form includes sections for personal information, employment history, residence history, education, references, citizenship status, military service, selective service, investigations record, foreign travel, police record, illegal drug use, and financial records.

The form requires detailed documentation including legal name changes, Social Security cards, birth certificates, and authorization for release of information to investigate the applicant's background, including criminal records, employment history, education records, and financial information. It includes specific release forms for both general background investigation information and medical information. The form must be completed in black ink, with all questions answered completely and truthfully, as false statements can result in fines up to $10,000 and/or 5 years imprisonment under U.S. Criminal Code Title 18, Section 1001. The form's estimated completion time is 60 minutes according to the public burden information section.