ID Information Direct - Application Notification / Release of Information
The purpose of this form is to notify you that a Consumer Report and/or Investigative Consumer Report will be conducted on you in the course of consideration for employment. I hereby authorize your company or any agent of your company to contact any and all corporations, former employers, credit agencies, educational institutions, law enforcement agencies, city, state, county, and federal courts and military services to release information about my background including, but not limited to, information about my employment, education, consumer credit history, driving record, criminal record, and general public records history to the person or company with which this form has been filed. This releases the aforesaid parties from any liability and responsibility for collecting the above information. This release shall remain in effect for the length of my employment. I understand I have the right to obtain a free copy of this consumer report if; (1) Any adverse action/decision is made based on the information in the consumer report, & (2) If the request is made in writing within 60 days of the adverse action. If an investigative consumer Report is conducted, I will be notified in writing within three days from the request of said report. I Believe to the best of my knowledge that all information I have provided is accurate true and correct and that I fully understand the terms of this release.
(This is not a secure form)
List State and License Number
List Street or PO Box#, City, State, Zip, and the dates
By typing your name this counts as your legal signature.
By typing your name above that counts as your legal signature.