DISCLOSURE:
This form, which you should read carefully, has been provided to you because
D + S Distribution, Inc .may request
consumer reports or investigative consumer reports, as defined by the Fair Credit Reporting Act, about you from a third party company engaged in the business of collecting this type of information –
Screenpointe, Inc | 1445 Worthington Woods Blvd Suite C, Worthington, OH 43085 | 1-877-891-3302 | compliance@screenpointe.com (“Screening Agent”) for the purposes set forth below in “Authorization.”
The types of reports that may be requested from consumer reporting agencies under this policy include, but are not limited to, civil and criminal court records, address history, driving records, credit reports, personal interviews, professional reference interviews, professional licensing, public records or information obtained from governmental or law enforcement agencies, summaries of educational and employment records and histories, and any other information bearing on my character, general reputation, personal characteristics, qualifications, skills, creditworthiness, and trustworthiness (“Screening Reports”). The information contained in these reports may be obtained by a Screening Agent from public record sources or through personal interviews with your co-workers, neighbors, friends, associated, current or former employers, or other personal acquaintances.
Should any of the information contained in the Consumer Report lead to adverse action for the purposes of employment, volunteer work or housing, The Fair Credit Reporting Act requires you to be provided with a copy of the Consumer Report and a summary of your rights under the FCRA. The above referenced Screening Agent is responsible for the compilation in whole or in part of the Consumer Report, however does not make determination or provide guidance or recommendations on worthiness of employment, housing or volunteer opportunity.
AUTHORIZATION:
I have carefully read and understand this notice, and by my consent below, I authorize the Company to procure Screening Reports as defined above from a Screening Agent. I understand that the Company may use the Screening Reports for the following purposes: (1) in conjunction with my engagement by the Company or (2) throughout the duration of my relationship with the Company for purposes of evaluating my suitability for continuing the relationship. I certify that this consent shall be in full force and effect for the duration of my engagement or employment by the Company.
I hereby authorize all persons and entities, including but not limited to, businesses, corporations, former employers, credit agencies, motor vehicle bureaus, governmental agencies, law enforcement authorities, courts, educational institutions, state insurance departments, private regulatory agencies and all military services to release all written and verbal information about me to the Company or the Screening Agent. I release and hold each harmless from all liability and responsibility for doing so.
I further understand that any and all information contained in my resume or otherwise disclosed to the Company or Screening Agent by me before, during or after my engagement or employment by the Company may be utilized for the purpose of obtaining the Screening Reports requested by the Company and certify that all such information provided in connection with my contract with the Company is true and correct. I understand and acknowledge that nothing in this notice and authorization is intended to be, or is, an offer of employment or engagement or a promise of continued engagement. I hereby authorize the Company to share the contents of the Consumer Report with its clients and partners as necessary prior to and during my engagement with the Company.
I further understand that I have specific prescribed rights as a consumer under the federal Fair Credit Reporting Act and may have additional rights under relevant state law. I hereby certify that I have read and/or downloaded a copy of and understand the
Summary of Rights under the Fair Credit Reporting Act.