Acknowledgment and Authorization for Background Check
I acknowledge receipt of the separate documents entitled Disclosure Regarding Background Investigation and A Summary of Your Rights Under the Fair Credit Reporting Act and certify that I have read and understand both of those documents. I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” by the Company at any time after receipt of this authorization and throughout my employment, if applicable and to the extent permitted by law. For the purpose of preparing a background check for Company, I hereby authorize any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, past or present employers, motor vehicle records agencies, or insurance company to furnish any and all background information requested by Checkr, Inc., One Montgomery Street, Suite 2000 San Francisco, CA 94104 | 8448243257 | https://checkr.com/applicant, as allowed by law, including information concerning my employment and earnings history, education, credit history, motor vehicle history, criminal history, military service, and professional credentials and licenses. I agree that an electronic copy of this Authorization shall be as valid as the original.
Massachusetts applicants only: Upon written request to the Company, you have the right to know whether the Company ordered an investigative consumer report about you. You also have the right to request from the consumer reporting agency a copy of any such report.
Minnesota applicants only: Upon a written request, you have the right to a complete and accurate disclosure of the nature and scope of any consumer report the Company ordered about you. The consumer reporting agency must provide you with this disclosure within 5 business days after its receipt of your request or the report was requested by the Company, whichever date is later.
Minnesota and Oklahoma applicants only:
Please check this box if you would like to receive a copy of a consumer report if one is obtained by the Company.
New Jersey applicants only: You have the right to submit a request to the CRA for a copy of any investigative consumer report the Company ordered about you.
New York applicants only: Upon request, you will be informed whether or not a consumer report was requested by the Company, and if such report was requested, informed of the name and address of the consumer reporting agency that furnished the report. You have the right to inspect and receive a copy of any investigative consumer report requested by the Company by contacting the consumer reporting agency identified above directly. By signing below, you acknowledge receipt of Article 23A of the New York Correction Law. Link to NY Article 23A
New York City applicants only: You acknowledge and authorize the Employer to provide any notices required by federal, state or local law to you at the address(es) and/or email address(es) you provided to the Employer.
Washington State applicants only: Upon written request to Company, you have the right to a complete and accurate disclosure of the nature and scope of any investigative consumer report the Company ordered about you. You are entitled to this disclosure within 5 business days after the date your request is received or we ordered the report, whichever is later. You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act.
Disclosure Regarding Background Investigation
Checkr (the “Company”) may obtain information about you from a third party consumer reporting agency for employment purposes. Thus, you may be the subject of a “consumer report” and/or an “investigative consumer report,” as defined in California, which may include information about your character, general reputation, personal characteristics, and/or mode of living, and which can involve personal interviews with sources such as your neighbors, friends, or associates. These reports may contain information regarding your criminal history, motor vehicle records (“driving records”), verification of your education or employment history, or other background checks.
You have the right, upon written request made within a reasonable time, to request whether a consumer report has been run about you, and disclosure of the nature and scope of any investigative consumer report and to request a copy of your report. Please be advised that the nature and scope of the most common form of investigative consumer report is an employment history or verification. These searches will be conducted by Checkr, Inc., One Montgomery Street, Suite 2000 San Francisco, CA 94104| 8448243257 | https://checkr.com/applicant. The scope of this disclosure is allencompassing, however, allowing the Company to obtain from any outside organization all manner of consumer reports throughout the course of your employment to the extent permitted by law.
A Summary of Your Rights Under the Fair Credit Reporting Act
The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.
• You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.
• You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
• a person has taken adverse action against you because of information in your credit report;
• you are the victim of identity theft and place a fraud alert in your file;
• your file contains inaccurate information as a result of fraud;
• you are on public assistance;
• you are unemployed but expect to apply for employment within 60 days.
In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.
• You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.
• You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.
• Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete, or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.
• Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.
• Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need -- usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.
• You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.
• You many limit “prescreened” offers of credit and insurance you get based on information in your credit report. Unsolicited “prescreened” offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt out with the nationwide credit bureaus at 1-888-5-OPTOUT (1-888-567-8688).
• You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.
• Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.
States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. For information about your federal rights, contact:
TYPE OF BUSINESS: CONTACT:
1.a. Banks, savings associations, and credit a. Consumer Financial Protection Bureau
unions with total assets of over $10 billion and 1700 G Street, N.W.
their affiliates Washington, DC 20552
b. Such affiliates that are not banks, savings b. Federal Trade Commission: Consumer
associations, or credit unions also should list, Response Center – FCRA
in addition to the CFPB: Washington, DC 20580
2. To the extent not included in item 1 above:
a. National banks, federal savings associations, a. Office of the Comptroller of the Currency
and federal branches and federal agencies of Customer Assistance Group
foreign banks 1301 McKinney Street, Suite 3450
b. State member banks, branches and agencies Houston, TX 77010-9050
of foreign banks (other than federal branches, b. Federal Reserve Consumer Help Center
federal agencies, and Insured State Branches of P.O. Box. 1200
Foreign Banks), commercial lending Minneapolis, MN 55480
companies owned or controlled by foreign
banks, and organizations operating under
section 25 or 25A of the Federal Reserve Act
c. Nonmember Insured Banks, Insured State c. FDIC Consumer Response Center
Branches of Foreign Banks, and insured state 1100 Walnut Street, Box #11
savings associations Kansas City, MO 64106
d. Federal Credit Unions d. National Credit Union Administration
Office of Consumer Protection (OCP)
Division of Consumer Compliance and
1775 Duke Street
Alexandria, VA 22314
3. Air carriers Asst. General Counsel for Aviation
Enforcement & Proceedings
Aviation Consumer Protection Division
Department of Transportation
1200 New Jersey Avenue, S.E.
Washington, DC 20590
4. Creditors Subject to the Surface Office of Proceedings, Surface Transportation
Transportation Board Board
Department of Transportation
395 E Street, S.W.
Washington, DC 20423
5. Creditors Subject to the Packers and Nearest Packers and Stockyards
Stockyards Act, 1921 Administration area supervisor
6. Small Business Investment Companies Associate Deputy Administrator for Capital
United States Small Business Administration
409 Third Street, S.W., 8th Floor
Washington, DC 20416
7. Brokers and Dealers Securities and Exchange Commission
100 F Street, N.E.
Washington, DC 20549
8. Federal Land Banks, Federal Land Bank Farm Credit Administration
Associations, Federal Intermediate Credit 1501 Farm Credit Drive
Banks, and Production Credit Associations McLean, VA 22102-5090
9. Retailers, Finance Companies, and All Other FTC Regional Office for region in which the
Creditors Not Listed Above creditor operates or Federal Trade
Commission: Consumer Response Center –
Washington, DC 20580