(UK) LIMITED

Earles Road Hedon Road Hull HU9 1UD Tel: 01482 312700 Fax: 01482 312701

COMMERCIAL VEHICLE DRIVER APPLICATION FORM Driver personal details Surname: CIOBANU Date of Birth: !"!#" $% Telephone number: Email Address: ti,eri-.dan/el0/a'oo"1o2 Address: Ploiesti, PH, Romania, 5 Varbilau Alley , Bl.153, Sc. E, Ap.3 Ho lon! at this address: sin1e Ma/ +! * 3'en I 1a2e ,a14 5ro2 U6 "re#ious address if less than t o $ears: ++ 7alt1otes Pla1e8 L/t'a2 Drivin9 Li1ense %i&ense number: "''()*++,H 2alid from: '(34435'46 -roups./ate!ories: A0 B0 /0 /1E E7pir$ date: 6434'35'4* First Name(s): TIBERIU-DANIEL Nat Ins Number: I don&t 'ave it Mobile number: !!("!)* "+##"!+)

Date dri#in! test as passed: A85''*0 B85''60 /8',35'460 /1E 9 4'35'46 L:V Li1ense Medi&al due: Di9ital Drivin9 Li1ense Do $ou possess one: E7pir$ date: 5534435'4* CPC ; Driver <-ali5i1ation Card Do $ou possess one: Da$s /ompleted: Additional =-ali5i1ations>e?perien1e Ha>ardous &hemi&als: :es ?ther 9 spe&if$ 2alid From: ',35'46 E7pir$ Date: 4'34435'4* :es E7pir$ Date: 4634435'4* :es /ard number: ''''''''';B<=''' Date %-2 dri#in! test passed:

Drivin9 e?perien1e@ Ha#e $ou underta@en an$ ad#an&ed dri#er.defensi#e dri#er trainin!A If $es0 !i#e dates and details: Ve'i1le E?perien1e ; NO EAPERIENCE EACEPT FOR THE DRIVIN: 7CHOOL "lease &onfirm from the belo list the #ehi&les and trailers $ou ha#e pre#iousl$ had e7perien&e dri#in! 2ol#o . S&ania . Mer&edes . Benault . I#e&o . DAF . MAN Manual . Automati& Tautliner . Tilt . Frid!es . /ontainer . Me!a Trailers :ive dates o5 an/ tra55i1 a11ident d-rin9 t'e last 5ive /ears@ NO ACCIDENT7 Date: Brief des&ription of a&&ident: an$ inCured part$: No

Endorse2ents>1onvi1tions8 in1l-din9 s-spensions@ NO Date: ?ffen&e: Endorsement &ode: Fine."enalt$ points:

Have /o- ever ,een 1onvi1ted o5 drivin9 -nder t'e in5l-en1e o5 al1o'ol or dr-9sB No If $es0 please !i#e date(s) and details: Cri2inal 1onvi1tions@ Ha#e $ou had an$ &on#i&tions in the last four $ears0 or an$ pendin!A /BB /he&@ &arried out (for offi&e use onl$) No :es.No

/BB /he&@ si!ned off b$ (name and date)DDDDDDDDDDDD33333333333333 Medi1al Are $ou in !ood healthA :es

Are $ou a are of an$ medi&al &ondition hi&h ma$ affe&t $our abilit$ to perform $our Cob safel$ ithout ris@ to $ourself or fello or@ers or other members of the publi&A No Is $our #ision impairedA No If $es0 hat t$pe of #isual &orre&tion do $ou ear (e! !lasses0 &onta&t lenses) Do $ou suffer from &olour #ision problemsA No Ha#e $ou e#er re&ei#ed medi&al treatment for: Diabetes No

Epileps$: Heart "roblems Do $ou suffer from: Di>>$ Spells Bla&@outs Abnormal Blood "ressure Sei>ure or Epilepti& fits Ba&@ problems. S&iati&a

No No No No No No No

Are $ou ta@in! an$ medi&ation hi&h ma$ affe&t $our abilit$ to perform $our Cob safel$A No "lease !i#e further details:

Do $ou suffer from an$ other illness.disabilit$ hi&h &ould affe&t $our dri#in! abilit$A No If $es0 please !i#e details:

Last t'ree e2plo/ers@ Name of emplo$er

Dates emplo$ed

Eob t$pe

Period Job position Main responsabilities / Activities ) ployer's na e and address /ype o# business or sector Period Job position Main responsabilities / Activities ) ployer's na e and address /ype o# business or sector

Jul 2012 May 2013 Catering Services Welco es custo ers! ta"ing orders! serving! speci#ic $!ta"e%a&ay'' activities( McCreedy *estaurant +i ited! +yt,a St( Annes! -. *estaurant / /a"e%a&ay

Mar 2000 1ct 2000 Co ercial 2irector 3egotiates and concludes sales contracts &it, a4or custo ers! Monitoring costs! )laborates budget #or revenues and e5penses( SC ) erald Product S*+! Ploiesti Production and ar"eting o# corrugated cardboard pac"agings

Period 1ct 2006 3ov 2007 Job position Assistant Manager Main responsabilities / Preparing Manager's Agenda! developing t,e relations,ip &it, t,e Activities suppliers and clients o# t,e co pany! translates t,e correspondence! preparing t,e contracts &it, t,e t,ird parties! "eeping pri ary accountancy 8orders! invoices! pay ent orders9(

) ployer's na e and address SC Albina Carpatica S*+! Ploiesti /ype o# business or sector Co erciali:ation o# li;uid #uels C+< and C+I HA2E D?/<MENTS T? "B?2E THAT I F?BGED IN <G3 BETFEEN 5'',85'45 9 I FAS A ST<DENT AT <"- <NI2EBSIT:

For o55i1e -se onl/ "re#ious emplo$er referen&es ta@en up (Atta&h &opies for file)

:es.No

Emplo$er referen&es &he&@ed b$DDDDDDDDDDDDDDDDDDD33 (?ffi&e use ?nl$)

I &ertif$ that all details abo#e are true and &omplete to the best of m$ @no led!e3

Si!ned TIBEBI< DANIE% /I?BAN<

Date ';3'535'4(