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Please note the following information is for educational purposes only and does not constitute legal advice. Please consult with counsel prior to using this form as part of your screening process.



I have carefully read and understand the FCRA Candidate Disclosure for the Procurement of Consumer

Reports form, and if applicable, the California Candidate Disclosure for the Procurement of Investigative

Consumer Reports form. I have also read and understand the attached Summary of Rights under the Fair

Credit Reporting Act and State Law Disclosures. By my signature below, I authorize the Company to share the

contents of this consumer report or investigative consumer report with its partners and clients in an effort to

place me into an employment/independent contractor/volunteer relationship with those partners. The

Company will only share the background report as necessary, and as authorized, in order to assign me to a

client, partner company, or organization. I understand that if the Company hires or engages me, my consent

will apply, and the Company may obtain reports throughout my employment/contract/tenurewhere state law

allows. I also understand that the information contained in my job application or otherwise disclosed by me

before or during my employment/contract/tenure, if any, may be used for the purpose of obtaining consumer

reports and/or investigative consumer reports.

By my signature below, I authorize law enforcement agencies, learning institutions (including public and

private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts

(federal, state and local), motor vehicle records agencies, my past or present employers, the military, and

other individuals and sources to furnish any and all information on me that is requested by the consumer

reporting agency.

If applicant is younger than 18 years old, a Legal Guardian must provide his/her own email address and

signature in the fields below.

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