Employment Application

Equal Opportunity Employer

Personal Information Date: _________________

1177 Avenue of the Americas, New York, NY 10036

Bank Hapoalim B.M. provides equal employment and individual opportunity to all job applicantsand employees without regard to race, color, religion, sex, sexual orientation, veteran status,

marital status, age, national origin, veteran or disability and any other status protected by law.

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Street Address (No., Street, Apt., No.)

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List a cell phone number and email address where you can be reached

How were you referred to Bank Hapoalim B.M.?

BH Employee Employment Agency Internet Newspaper Ad Other Referral

(Name) (Name of Firm) (Source) (Which paper) (Please explain)

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Rev. 7/07

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Page 2

Are you legally authorized to work in the United States? Yes No

Will you now or in the future require sponsorship for employment visa status (e.g. H-1B visa?) Yes No

Are you at least 18 years of age and, if not, do you have valid working papers? Yes NoAre you able to perform the functions of the job with or without reasonable accommodations? Yes No

If No, please describe any accommodation required:

Are you available to work overtime if requested? Yes No

Have you been employed by or previously applied to Bank Hapoalim B.M. or any of its subsidiaries? Yes No

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Does Bank Hapoalim B.M. now employ any of your relatives? Yes No

If Yes, state name and relationship:

Is additional information relative to a change of name, use of an assumed name or nicknamenecessary to enable a check on your work record? Yes No

If Yes, what name?

Have you ever been convicted of an offense other than a minor traffic violation? Yes No

If Yes, please note that a conviction or a pending criminal case will not result in an automatic disqualification fromemployment. The date(s), nature, seriousness of the offense, and rehabilitation will be considered. However, please beadvised that Section 19 of the Federal Deposit Insurance Act states that without the written permission of the FDIC, noperson who has been convicted of any criminal offense involving dishonesty or a breach of trust or money launderingmay participate, directly or indirectly, in the conduct of the affairs of an insured bank.

If Yes, state date, place, and nature of each conviction.

Bank Hapoalim B.M. verifies the information provided by you in your application for employment, including educational and employment references. As part of the verification process, you may be asked to provide copiesof degrees/diplomas. Bank Hapoalim B.M. may terminate your employment upon discovery of any discrepancy.Please ensure that all of the information you provided is correct and that the dates, degrees received and educational information is accurate.

EducationNumber of Did you Degree Rec’d Credits

Name and Address of School years completed graduate? Courses/Major completed

High School

College

GraduateSchool

SupplementalEducation

Are you currently attending school? Yes No

If Yes, name of school, days and times attending:

If No, do you plan to return? Yes ( F/T P/T ) No

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EmploymentInclude U.S. Military service only if relevant. Do not show type of discharge.

May we contact your present employer? Yes, you may contact anytime Yes, contact upon acceptance of employment

From Mo/Yr to Mo/Yr Name and Address of most recent employer

List your current or most recent employer first and indicate a continuous record of employment for the last ten years orfrom the time you left school.

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Reason for Leaving Supervisor’s Name and Phone No. Starting Salary Final Salary Other Comp.

From Mo/Yr to Mo/Yr Name and Address of most recent employer

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Reason for Leaving Supervisor’s Name and Phone No. Starting Salary Final Salary Other Comp.

From Mo/Yr to Mo/Yr Name and Address of most recent employer

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Reason for Leaving Supervisor’s Name and Phone No. Starting Salary Final Salary Other Comp.

From Mo/Yr to Mo/Yr Name and Address of most recent employer

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Reason for Leaving Supervisor’s Name and Phone No. Starting Salary Final Salary Other Comp.

Fluency(circle one)

SpeakBasic Inter. Adv.

ReadBasic Inter. Adv.

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SpeakBasic Inter. Adv.

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Fluency(circle one)

Speak Basic Inter. Adv.

Read Basic Inter. Adv.

Write Basic Inter. Adv.

EXPLAIN ANY GAPS IN EMPLOYMENT:

Skills Do Not Complete Unless Boxes Below Identify Specific Languages

Basic Inter. Adv.

Basic Inter. Adv.

Basic Inter. Adv.

Basic Inter. Adv.

Basic Inter. Adv.

PC Software Proficiency Languages other than English (complete only if required for position)

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Please read the following statements carefully as they represent matters of importance to both you and Bank Hapoalim B.M.regarding this employment application:

THIS SECTION PERTAINS ONLY TO DISABLED PERSONS. A “Disabled Person” refers to any person who has a physical ormental impairment that substantially limits one or more major life activities (performing manual tasks, learning, walking, seeing, hearing,speaking, etc.), has a record of such an impairment or is regarded as having such an impairment. Bank Hapoalim B.M. is a GovernmentContractor subject to Section 503 of the Rehabilitation Act of 1973 which requires employers to take affirmative action to employ andadvance in employment qualified disabled individuals. If you feel you meet the above definition of “Disabled,” Bank Hapoalim B.M.invites you to inform us so that you may be given consideration under our Affirmative Action Program.

Provision of this information is entirely voluntary, and choosing not to provide it will not result in any adverse treatment. The information willbe used only according to the regulation of the Act and will be kept in the individual’s personnel file. The information is consideredconfidential, except that, (1) Supervisors may be informed regarding restrictions on the work or duties of handicapped persons and any necessary accommodations; (2) First Aid personnel may be informed, where appropriate, if the condition might require emergency treat-ment; and (3) Government officials investigating compliance with the Act shall be informed.

PLEASE DESCRIBE DISABILITY:

If you have a disability which might affect your performance or create a hazard to yourself or others in connection with the job for whichyou are applying, please indicate below (1) the skills, procedures and aids you use or intend to use to perform the job and (2) the accom-modations Bank Hapoalim B.M. could make which would enable you to perform the job properly and safely, such as special equipment,changes in the physical layout of the job, and/or changes in certain duties of the job.

Are you presently a director, employee or officer of a bank located in the United States that is unaffiliated with Bank Hapoalim B.M.? Yes No

Do you intend to continue in that capacity if hired by Bank Hapoalim B.M.? Yes No

If Yes, please give the name of the Bank:

Do you currently hold a position of employment for pay in any organization outside of Bank Hapoalim B.M.not mentioned above in which you plan to continue working if employed by Bank Hapoalim B.M.? Yes No

If Yes, please provide the following information:

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Signature of Applicant Date

I certify that the information given by me in this application is true and complete. I understand and agree that any false information, misrepre-sentation, or concealment of fact will result in my immediate discharge without recourse or in refusal of employment by Bank Hapoalim B.M.

I understand and agree that all information furnished in this application may be verified by Bank Hapoalim B.M. I also understand that myemployment is subject to a satisfactory check of references and satisfactory results of any medical examination that the Bank may require.I hereby authorize all individuals and organizations named or referred to in this application and any law enforcement organization to giveBank Hapoalim B.M. all information relative to my employment, work habits, and character and hereby release such individuals, organiza-tions, and Bank Hapoalim B.M. from any liability for any claim or damage which may result.

In connection with this application, or during the course of my employment, I understand that Bank Hapoalim B.M. may request that aConsumer Reporting Agency prepare a report regarding my credit worthiness, credit standing and credit capacity, character, general repu-tation, personal characteristics and mode of living. I further understand that upon my request, Bank Hapoalim B.M. will inform me whetheror not a consumer report was requested and, if a report was requested, will inform me of the name and address of the agency furnishingthe report. I further understand that upon my written request made within a reasonable period of time, I have the right to inspect and receivea copy of such report by contacting the agency.

In the event I am hired, I agree to comply with Bank Hapoalim B.M.’s policies and procedures. Further, I understand and agree that myemployment is “at will,” shall be for no definite period and, regardless of the date of payment of my salary, shall be terminable at any timeby me or the Bank, for any reason and without any previous notice.

Signature of Applicant Date

INVITATION TO APPLICANTS FOR EMPLOYMENT TO IDENTIFY THEMSELVES AS DISABLED

CONFLICT OF INTEREST

DECLARATION OF APPLICANT (PLEASE READ BEFORE SIGNING)

FOR HUMAN RESOURCES DEPARTMENT USE ONLY

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Comments:

Disposition:

Thank you for considering as your prospective employer.

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