PERSONAL AND CONFIDENTIAL

THIS PAGE CONTAINS SENSITIVE INFORMATION. KEEP ONLY IN SECURE FILES. SEPARATELY FROM PERSONNEL RECORDS! 

Disclosure to Employment Applicant

Regarding Procurement of A Consumer Report

In connection with your application for employment, we may procure a consumer report on you as part of the process of considering your candidacy as an employee. In the event that information from the report is utilized in whole or in part in making an adverse decision with regard to your potential employment, before making the adverse decision, we will provide you with a copy of the consumer report and a description in writing of your rights under the law.



Please be advised that we may also obtain an investigative report including information as to your character, general reputation, personal characteristics, and mode of living. This information may be obtained by contacting your previous employers or references supplied by you. Please be advised that you have the right to request, in writing, within a reasonable time, that we make a complete and accurate disclosure of the nature and scope of the information requested. Such disclosure will be made to you within 5 days of the date on which we receive the request from you or within 5 days of the time the report was first requested.

The Fair Credit Reporting Act gives you specific rights ill dealing with consumer reporting agencies. You will find these rights summarized on the reverse side of this document. 


By your signature below, you hereby authorize us to obtain a consumer report about you in order to consider you for employment. 


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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 http://www.ftc.gov/credit or write to: Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Ave. N.W., Washington, DC 20580. 
• 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 identify 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, by September 2005 all consumers will be entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.ftc.gov/credit 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.ftc.gov/credit  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 correct, 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 species 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.ftc.gov/credit
• You may 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 1-888-567-8688. 
• 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.ftc.gov/credit
States may enforce the FCRA, and many states have their own consumer reporting Jaws. In same cases, yo u may have more rights under state l·aw. For more information, contact your state or local consumer protection agency or your state Attorney General. Federal enforcers are: 
TYPE OF BUSINESS:
CONTACT:
Consumer reporting agencies creditors and others not listed below
Federal Trade Commission: Consumer Response Center
FCRA 
Washington, DC 20580
National banks, federal branches/agencies of foreign banks (word "National" or initials "N.A." appear in or after bank's name)
Office of the Comptroller of the  Currency Compliance Management Mail Stop 6-6 Washington, DC 20219 
Federal Reserve System member banks (except national banks and federal branches/agencies of foreign banks) 
Federal Reserve Board Division of Consumer & Community Affairs Washington, DC 20551 
Savings associations and federally chartered savings banks (word "Federal" or initials "F.S.B." appear in federal institution's flame) 
Office of thrift Supervision Consumer Complaints Washington, DC 20552 
Federal credit unions (words "Federal Credit Union" appear in institution's name)
National Credit Union Administration 1775 Duke Street Alexandria, VA 22314 
State-chartered banks that are not members of the Federal Reserve System 
Federal Deposit Insurance Corporation Consumer Response Center 2.345 Grand Avenue, Suite 100 Kansas City, Missouri 64108-2630
Air, surface, or rail Gammon carriers regulated by former Civil Aeronautics Board or Interstate Commerce Commission
Department of Transportation Office Bf financial Management Washington, DC 20590  
Activities subject to the Packers and Stockyards Act Bf 1921 
Department of Agriculture Office of Deputy Administrator GIPSA Washington, DC 20250
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