Dow Corning Corporation U.S. Employment Application. PERSONAL DATA Name (Last) (First) (Middle) (Nickname) Application Date Today s Date

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1 Dw Crning Crpratin U.S. Emplyment Applicatin Midland, Michigan (frm t be used fr applicatin t Dw Crning Crpratin and subsidiaries) PERSONAL DATA Name (Last) (First) (Middle) (Nickname) Applicatin Date Tday s Date Telephne Fax Present Address (Number) (Street) (City) (State) (Zip Cde) Phne Number Permanent Address (Number) (Street) (City) (State) (Zip Cde) Alternate Phne Number Address Hw did yu hear abut us? Are yu a U.S. citizen, U.S. lawful permanent resident, asylee r refugee? Yes N If n, d yu have the legal right t wrk in the U.S.? Yes N If yes, please indicate the categry f wrk authrizatin: Have yu ever been cnvicted f a felny, r are there any felny charges pending against yu? Yes N If s, indicate when and nature f ffense: Have yu ever been emplyed by Dw Crning r a subsidiary? Yes N If yes, state where and dates: Salary range within which yu wuld cnsider a psitin per year Date available fr emplyment EDUCATION Educatinal Institutin Name City, State Attended Enrlled Graduated Majr Degree Grade Pint Ave. e.g. 2.9/4.0 Graduatin Year List additinal certificatins: U.S. MILITARY DATA (IF APPLICABLE) M. Frm Yr. M. T Yr. Military Assignment and Type f Activity Highest Rank and Special Training WORK EXPERIENCE DURING THE LAST TEN YEARS Start with last emplyer and attach a list f any additinal emplyment as necessary. Cmpany Name Jb Title Frm (M/Yr) / T (M/Yr) Address Final Mnthly Earnings FT r PT Name f Immediate Supervisr Phne Number Respnsibilities Reasn fr Leaving

2 WORK EXPERIENCE DURING THE LAST TEN YEARS (cntinued) Cmpany Name Jb Title Frm (M/Yr) / T (M/Yr) Address Final Mnthly Earnings FT r PT Name f Immediate Supervisr Phne Number Respnsibilities Reasn fr Leaving Cmpany Name Jb Title Frm (M/Yr) / T (M/Yr) Address Final Mnthly Earnings FT r PT Name f Immediate Supervisr Phne Number Respnsibilities Reasn fr Leaving Please prvide additinal infrmatin regarding yur educatinal, prfessinal and/r cmmunity experience that yu feel wuld be helpful t us in cnsidering yur applicatin (yu can exclude all infrmatin indicative f age, sex, race, religin, clr, natinal rigin, and disability). Attach a list f additinal infrmatin if necessary. Have yu ever been fired, dismissed, asked t resign, resigned by mutual agreement, r therwise been terminated frm any jb? Yes N If yes, what jb and why? Please read carefully: Certificatin and Agreement In cnsideratin f any emplyment that may be ffered t me by Dw Crning Crpratin, I agree that my emplyment and cmpensatin can be terminated, with r withut cause, and with r withut ntice, at any time, at the ptin f either Dw Crning crpratin r myself. Only the Chairman r President has the authrity t change the abve and the change must be in writing. I acknwledge that n ral representatins r assurances f any kind changes this at-will emplyment relatinship in any way. I understand that any psitin ffered t me by Dw Crning Crpratin is cnditinal upn my cmpletin f a rutine medical examinatin which will include passing the substance abuse screening. I understand that it is custmary fr cmpanies t investigate infrmatin furnished in emplyment applicatins and that my emplyment, at Dw Crning Crpratin s ptin, may be cntingent upn its accuracy. I, therefre, authrize investigatin f all matters herein: May we cntact yur present emplyer? (Please check ne) Yes N Nt Applicable Authrizatin t Wrk: I agree that if I am selected fr hire I will certify and prduce dcumentatin that I am authrized t wrk as required by the Immigratin Refrm and Cntrl Act f 1986 and ther applicable laws. Yes N Limitatins n Claims: I agree that any claim r suit against Dw Crning Crpratin and/r its agents, including but nt limited t claims related t my applicatin, emplyment r separatin frm emplyment and claims arising under State r Federal civil rights statutes, must be brught within the fllwing time limits r be frever barred: (a) fr lawsuits requiring a Ntice f Right t Sue frm the EEOC, within 90 days after the EEOC issues that Ntice; r (b) fr all ther claims, within (i) 180 days f the event(s) giving rise t the claim, r (ii) the time limit specified by statute, whichever is shrter. I waive any statute f limitatins that exceeds this time limit. Yes N Disability Accmmdatin: If I need an accmmdatin f a disability in rder t perfrm the jb fr which I am applying r t cmplete the applicatin prcess, I understand that Michigan law requires that I ntify Dw Crning Crpratin f this need in writing within 182 days after I knew r reasnably shuld have knwn f it. Yes N Certificatin: I certify that all infrmatin n this applicatin is accurate t the best f my knwledge. By submitting my electrnic applicatin, I acknwledge that I have been given adequate time t read, cmplete and review this Applicatin, Certificatin and Agreement, and the Candidate Release Authrizatin. I als understand that a false, misleading r deliberately cmmitted infractin in my applicatin is justificatin fr refusal r terminatin f emplyment at Dw Crning Crpratin. I have submitted this Applicatin and Certificatin and Agreement knwingly and vluntarily. Yes N I certify that all infrmatin n this applicatin is accurate t the best f my knwledge. I als understand that false, misleading r deliberate missin f a statement in my applicatin is justificatin fr refusal f emplyment at Dw Crning Crpratin. Signature: Date: Any items n this frm which yu feel vilate Federal r State civil rights legislatin need nt be cmpleted. We hire nly U.S. citizens and lawfully authrized alien wrkers. Applicatins t Dw Crning subsidiaries r ther rganizatins are cnsidered t be applicatins f these rganizatins exclusively and nt applicatins f Dw Crning Crpratin. Dw Crning Crpratin and its subsidiaries are Equal Opprtunity Emplyer s M/F/D/V

3 Cnsent t Request Cnsumer Reprt & Investigative Cnsumer Reprt Infrmatin Applicant's First Name r Initial Last Name I understand that ( COMPANY ) will use Sterling InfSystems Inc., 249 West 17th Street, New Yrk, NY 10011, (877) t btain a cnsumer reprt and/r investigative cnsumer reprt ( Reprt ) as part f the hiring prcess. I als understand that if hired, t the extent permitted by law, COMPANY may btain further Reprts frm STERLING s as t update, renew r extend my emplyment. I understand Sterling InfSystems Inc. s ( STERLING ) investigatin may include btaining infrmatin regarding my credit backgrund, bankruptcies, lawsuits, judgments, paid tax liens, unlawful detainer actins, failure t pay spusal r child supprt, accunts placed fr cllectin, character, general reputatin, persnal characteristics and standard f living, driving recrd and criminal recrd, subject t any limitatins impsed by applicable federal and state law. I understand such infrmatin may be btained thrugh direct r indirect cntact with frmer emplyers, schls, financial institutins, landlrds and public agencies r ther persns wh may have such knwledge. If an investigative cnsumer reprt is being requested, I understand such infrmatin may be btained thrugh any means, including but nt limited t persnal interviews with my acquaintances and/r assciates r with thers whm I am acquainted. The nature and scpe f the investigatin sught is as fllws: [Be Specific] I acknwledge receipt f the attached summary f my rights under the Fair Credit Reprting Act and, as required by law, any related state summary f rights (cllectively Summaries f Rights ). This cnsent will nt affect my ability t questin r dispute the accuracy f any infrmatin cntained in a Reprt. I understand if COMPANY makes a cnditinal decisin t disqualify me based all r in part n my Reprt, I will be prvided with a cpy f the Reprt and anther cpy f the Summaries f Rights, and if I disagree with the accuracy f the purprted disqualifying infrmatin in the Reprt, I must ntify COMPANY within five business days f my receipt f the Reprt that I am challenging the accuracy f such infrmatin with STERLING. I hereby cnsent t this investigatin and authrize COMPANY t prcure a Reprt n my backgrund. In rder t verify my identity fr the purpses f Reprt preparatin, I am vluntarily releasing my date f birth, scial security number and the ther infrmatin and fully understand that all emplyment decisins are based n legitimate nn-discriminatry reasns. Califrnia, Massachusetts, Minnesta, New Jersey & Oklahma Applicants Only: I have the right t request a cpy f any Reprt btained by COMPANY frm STERLING by checking the bx. STERLING will mail the Reprt directly t me. (Check nly if yu wish t receive a cpy) Maine Applicants Only: By checking the bx, I indicate that I wish t receive the name, address and telephne number f the nearest unit f the cnsumer reprting agency designated t handle inquiries regarding the investigative cnsumer reprt as well as receive a cpy f any reprt btained by Cmpany frm Sterling. Washingtn State and Oregn Applicants Only (AS APPLICABLE): I further understand that COMPANY will nt btain infrmatin abut my credit histry, credit wrthiness, credit standing, r credit capacity unless: (i) the infrmatin is required by law, (ii) the infrmatin is substantially jb related, and the reasns fr using the infrmatin are disclsed t me in writing, (If this ptin is checked, cmplete the questin belw) r (iii) I am seeking emplyment as a cvered plice r peace fficer r with a federally insured bank r credit unin (Oregn nly). Reasns why COMPANY cnsiders credit infrmatin substantially jb related (cmplete if this is the sle basis fr btaining credit infrmatin): NY Applicants Only: I als acknwledge that I have received the attached cpy f Article 23A f New Yrk s Crrectin Law. I further understand that I may request a cpy f any investigative cnsumer reprt by cntacting STERLING. I further understand that I will be advised if any further checks are requested and prvided the name and address f the cnsumer reprting agency. Califrnia Applicants and Residents: If I am applying fr emplyment in Califrnia r reside in Califrnia, I understand I have the right t visually inspect the files cncerning me maintained by an investigative cnsumer reprting agency during nrmal business hurs and upn reasnable ntice. The inspectin can be dne in persn, and, if I appear in persn and furnish prper identificatin; I am entitled t a cpy f the file fr a fee nt t exceed the actual csts f duplicatin. I am entitled t be accmpanied by ne persn f my chsing, wh shall furnish reasnable identificatin. The inspectin can als be dne via certified mail if I make a written request, with prper identificatin, fr cpies t be sent t a specified addressee. I can als request a summary f the infrmatin t be prvided by telephne if I make a written request, with prper identificatin fr telephne disclsure, and the tll charge, if any, fr the telephne call is prepaid by r directly charged t me. I further understand that the investigative cnsumer reprting agency shall prvide trained persnnel t explain t me any f the infrmatin furnished t me; I shall receive frm the investigative cnsumer reprting agency a written explanatin f any cded infrmatin cntained in files maintained n me. Prper identificatin as used in this paragraph means infrmatin generally deemed sufficient t identify a persn, including dcuments such as a valid driver s license, scial security accunt number, military identificatin card and credit cards. Signature: Tday s Date: erlinginfsyst ems.cm USCACDEN-V02 Page 1 f West 17t h St reet, 6 th Flr, New Yrk, NY Telephne Facsimile

4 Fr Office Use Only Grup ID (ptinal) Fr Office Use Only User ID (ptinal) Fr Office Use Only Lcatin / Stre # (ptinal) First Name Middle Name r Initial Last Name Date f Birth (MMDDYYYY) Other Names Knwn By Male Female Scial Security Number Primary Telephne Number (n dashes) Current Address Apt # #yrs at this address City State Zip Cde Previus Address Apt # #yrs at this address City State Zip Cde Driver s License Number (n dashes) License State Address Signature Tday s Date (MMDDYYYY) erlinginfsyst ems.cm USCACDEN-V02 Page 2 f West 1 7t h St reet, 6 th Flr, New Yrk, NY Telephne Facsimile

5 Para infrmacin en espanl, visite escribe a la FTC Cnsumer Respnse Center, Rm 130-A 600 Pennsylvania Ave. N.W., Washingtn, D.C A Summary f Yur Rights Under the Fair Credit Reprting Act The federal Fair Credit Reprting Act (FCRA) prmtes the accuracy, fairness, and privacy f infrmatin in the files f cnsumer reprting agencies. There are many types f cnsumer reprting agencies, including credit bureaus and specialty agencies (such as agencies that sell infrmatin abut check writing histries, medical recrds, and rental histry recrds). Here is a summary f yur majr rights under the FCRA. Fr mre infrmatin, including infrmatin abut additinal rights, g t r write t: Cnsumer Respnse Center, Rm 130-A, Federal Trade Cmmissin, 600 Pennsylvania Ave. N.W., Washingtn, D.C Yu must be tld if infrmatin in yur file has been used against yu. Anyne wh uses a credit reprt r anther type f cnsumer reprt t deny yur applicatin fr credit, insurance, r emplyment r t take anther adverse actin against yu must tell yu, and must give yu the name, address, and phne number f the agency that prvided the infrmatin. Yu have the right t knw what is in yur file. Yu may request and btain all the infrmatin abut yu in the files f a cnsumer reprting agency (yur file disclsure ). Yu will be required t prvide prper identificatin, which may include yur Scial Security number. In many cases, the disclsure will be free. Yu are entitled t a free file disclsure if: a persn has taken adverse actin against yu because f infrmatin in yur credit reprt; yu are the victim f identify theft and place a fraud alert in yur file; yur file cntains inaccurate infrmatin as a result f fraud; yu are n public assistance; yu are unemplyed but expect t apply fr emplyment within 60 days. In additin, by September 2005 all cnsumers will be entitled t ne free disclsure every 12 mnths upn request frm each natinwide credit bureau and frm natinwide specialty cnsumer reprting agencies. See fr additinal infrmatin. Yu have the right t ask fr a credit scre. Credit scres are numerical summaries f yur credit-wrthiness based n infrmatin frm credit bureaus. Yu may request a credit scre frm cnsumer reprting agencies that create scres r distribute scres used in residential real prperty lans, but yu will have t pay fr it. In sme mrtgage transactins, yu will receive credit scre infrmatin fr free frm the mrtgage lender. Yu have the right t dispute incmplete r inaccurate infrmatin. If yu identify infrmatin in yur file that is incmplete r inaccurate, and reprt it t the cnsumer reprting agency, the agency must investigate unless yur dispute is frivlus. See an explanatin f dispute prcedures. Cnsumer reprting agencies must crrect r delete inaccurate, incmplete, r unverifiable infrmatin. Inaccurate, incmplete r unverifiable infrmatin must be remved r crrected, usually within 30 days. Hwever, a cnsumer reprting agency may cntinue t reprt infrmatin it has verified as accurate. Cnsumer reprting agencies may nt reprt utdated negative infrmatin. In mst cases, a cnsumer reprting agency may nt reprt negative infrmatin that is mre than seven years ld, r bankruptcies that are mre than 10 years ld. Access t yur file is limited. A cnsumer reprting agency may prvide infrmatin abut yu nly t peple with a valid need -- usually t cnsider an applicatin with a creditr, insurer, emplyer, landlrd, r ther business. The FCRA specifies thse with a valid need fr access. Yu must give yur cnsent fr reprts t be prvided t emplyers. A cnsumer-reprting agency may nt give ut infrmatin abut yu t yur emplyer, r a ptential emplyer, withut yur written cnsent given t the emplyer. Written cnsent generally is nt required in the trucking industry. Fr mre infrmatin, g t erlinginfsyst ems.cm USCACDEN-V02 Page 3 f West 1 7t h St reet, 6 th Flr, New Yrk, NY Telephne Facsimile

6 Yu may limit prescreened ffers f credit and insurance yu get based n infrmatin in yur credit reprt. Unslicited prescreened ffers fr credit and insurance must include a tll-free phne number yu can call if yu chse t remve yur name and address frm the lists these ffers are based n. Yu may pt-ut with the natinwide credit bureaus at OPTOUT ( ). Yu may seek damages frm vilatrs. If a cnsumer reprting agency, r, in sme cases, a user f cnsumer reprts r a furnisher f infrmatin t a cnsumer reprting agency vilates the FCRA, yu may be able t sue in state r federal curt. Identity theft victims and active duty military persnnel have additinal rights. Fr mre infrmatin, visit States may enfrce the FCRA, and many states have their wn cnsumer reprting laws. In sme cases, yu may have mre rights under state law. Fr mre infrmatin, cntact yur state r lcal cnsumer prtectin agency r yur state Attrney General. Federal enfrcers are: FOR QUESTIONS OR CONCERNS REGARDING Cnsumer reprting agencies, creditrs and thers nt listed belw Natinal banks, federal branches/agencies f freign banks (wrd "Natinal" r initials "N.A." appear in r after bank's name) Federal Reserve System member banks (except natinal banks, and federal branches/agencies f freign banks) Savings assciatins and federally chartered savings banks (wrd "Federal" r initials "F.S.B." appear in federal institutin's name) Federal credit unins (wrds "Federal Credit Unin" appear in institutin's name) State-chartered banks that are nt members f the Federal Reserve System Air, surface, r rail cmmn carriers regulated by frmer Civil Aernautics Bard r Interstate Cmmerce Cmmissin Activities subject t the Packers and Stckyards Act, 1921 PLEASE CONTACT Federal Trade Cmmissin Cnsumer Respnse Center- FCRA Washingtn, DC Office f the Cmptrller f the Currency Cmpliance Management, Mail Stp 6-6 Washingtn, DC Federal Reserve Bard Divisin f Cnsumer & Cmmunity Affairs Washingtn, DC Office f Thrift Supervisin Cnsumer Prgrams Washingtn D.C Natinal Credit Unin Administratin 1775 Duke Street Alexandria, VA Federal Depsit Insurance Crpratin Divisin f Cmpliance & Cnsumer Affairs Washingtn, DC Department f Transprtatin Office f Financial Management Washingtn, DC Department f Agriculture Office f Deputy Administratr-GIPSA Washingtn, DC erlinginfsyst ems.cm USCACDEN-V02 Page 4 f West 1 7t h St reet, 6 th Flr, New Yrk, NY Telephne Facsimile

7 EXPORT CONTROL COMPLIANCE QUESTIONNAIRE U.S. exprt cntrl laws, including the Exprt Administratin Regulatins ( EAR ), Internatinal Traffic in Arms Regulatins ( ITAR ) and Office f Freign Assets Cntrl ( OFAC ) regulatins, require that Dw Crning Crpratin btain an exprt license prir t prviding cntrlled technlgies t certain freign natinals. The fllwing questins are being asked t assess whether yu are subject t these prvisins and, if s, t determine yur cuntry f chargeability fr exprt cntrl screening purpses nly. This infrmatin will nt be used fr any imprper purpse. 1. ARE YOU ONE OF THE FOLLOWING: Citizen r Natinal f the United States. U.S. Lawful Permanent Resident. Persn granted Refugee status. Persn granted Asylum. Temprary Resident (Granted under Amnesty r Special Agricultural Wrker prvisins. The term Temprary Resident des nt include persns in nnimmigrant status such as H-1B, L-1, F-1, etc.) Yes N Imprtant Nte: If yur answer t Questin 1 abve is Yes, please d nt answer any f the fllwing questins. Rather, g directly t the Signature Sectin at the end f this frm. If yur answer t Questin 1 is N, please prceed t Questin Please state yur cuntry f birth. 3. Have yu ever acquired citizenship, natinality, r permanent resident status in a cuntry ther than yur place f birth? Yes N If Yes, please prvide details (cuntry(s), type f status, date f acquisitin). 4. Have yur ever relinquished, abandned, r lst citizenship, natinality r permanent residence in any cuntry, including yur cuntry f birth? Yes N If Yes, please prvide details (cuntry(s), status relinquished/abandned/lst, date f relinquishment/abandnment/lss): SIGNATURE SECTION I understand that Dw Crning Crpratin reserves the right t inquire further n any matter related t matters bearing n Dw Crning Crpratin s exprt cmpliance bligatins. I certify that the freging answers are true and crrect t the best f my knwledge and belief. Signature: Date: Print Name: