Sample Background And Credit Check Authorization Form
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AUTHORIZATION By signing your name below you : Indicate you have carefully read and understand this Disclosure and Authorization form Consent to the release of consumer reports to the Company in conjunction with your job application Understand that if the Company hires you, your consent will apply throughout your employment unless you revoke or cancel your consent in writing by sending a signed letter or statement to the company Authorize the disclosure to HireRight of information concerning your employment history, earning history, education, criminal history, credit history (when pertinent to the position being applied for) and motor vehicle history (when pertinent to the position being applied for).. appear in federal institution s name) 20552 800-842-6929 Federal credit unions (words "Federal Credit Union" appear in institution s name) National Credit Union Administration 1775 Duke Street Alexandria, VA 22314 703-519-4600 State-chartered banks that are not members of the Federal Reserve System Federal Deposit Insurance Corporation Consumer Response Center, 2345 Grand Avenue, Suite 100 Kansas City, Missouri 64108-2638 1877-275-3342 Air, surface, or rail common carriers regulated by former Civil Aeronautics Board or Interstate Commerce Commission Department of Transportation , Office of Financial Management Washington, DC 20590 202-366-1306 Activities subject to the Packers and Stockyards Act, 1921 Department of Agriculture Office of Deputy Administrator - GIPSA Washington, DC 20250 202-720-7051.
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