Current (or most recent) employer.
Do you agree to inquiries being made as to the accuracy of information contained in this application form, or any other matter relating to your suitability for employment from your:
By stating my name and signing below I declare that to the best of my knowledge, the answers to the questions in this application are correct. I understand that if any false information is given, or any material fact suppressed, I may not be accepted, or if I am employed, I may be dismissed. I also understand that any false information given in section 7, the medical portion of this form may result in my loss of entitlement for any compensation from ACC.