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Consent To Services
Prior to conducting any background search (also referred to as a "consumer report"), you must have your applicant sign a form that substantially says the following (please note that the form below is being provided for informational purposes only and may be incomplete and deficient pursuant to relvant state law or a recent act of congress or your state legislature - check with an attorney who specializes in FCRA Compliance / Employment Law for the legal requirements in your particular state - e.g. in some states, the applicant must be given the right to recieve a copy of their consumer report; while in others, employers need only inform potential applicants if a consumer report is ordered):
Consumer Report Authorization
I, ____________, understand that a consumer report or investigative consumer report ("Consumer Report") may be prepared about me, as part of my application for employment and/or continued employement with ___________, or any of its affiliated entities.
I hereby authorize _______________, and ScreentoHire.com to obtain information from government agencies, credit reporting agencies, law enforcement agencies (at the county, state, national/federal, and international level), courthouses, county clerk offices, any public/governmental authority or holder of public records, or any privately complied database, relating to my past activities and other current or historical information pertaining to my background. Such information may pertain, but is not limited to: criminal history, personal history, relevant litigation (criminal and civil), credit reports, and driving records.
I understand and acknowledge that the foregoing information about me may be transmitted electronically, and when required, across interstate and international lines.
I understand that I may request a copy of any report that is prepared regarding me and "A Summary of Your Rights under the Fair Credit Reporting Act." I may also request the nature and substance of all information about me contained in the files of the consumer-reporting agency. I understand I have the right to inspect those files with reasonable notice during regular business hours and I may be accompanied by one other person. The consumer-reporting agency is required to provide someone to explain the contents of my file. I understand that proper identification will be required and I should direct my request to: _________________________________/ phone.
Signed,
____(signature)____, Date:_____________
First Name:
Middle Name:
Last Name:
DOB:
SS#:
Drivers License#/state:
Any other names you have used in the past 7 years
(e.g. maiden, aliases, nicknames, changed names):