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Pre Employment Form
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(AC41)
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(HE44)
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(WR45)
(DS49)
In connection with my application for employment with
Company Name
, I understand that several investigative-consumer reports may be requested any may include information as to my character, general reputation, personal characteristics, and mode of living, work habits, credit, academic-credential verification, job performance, experience and reason for termination. Further I understand that you may be requesting information concerning my worker’s compensation claims, motor vehicle operations history, and criminal history from various private and public sources along with other public records available. According to the Fair Credit Report Act, I am entitled to receive a summary of my rights and have the right to request additional disclosures as follows: Upon my written request to
Company Name
within a reasonable period of time after my receipt of this disclosure
Company Name
shall make a complete and accurate disclosure of the nature and scope of the investigative requested, along with the name, address and telephone number of the consumer reporting agency that provided the investigative report to
Company Name
and that this disclosure shall be made in writing and delivered to me no later than five days after the date on which
Company Name
receives my request or five days after I request the disclosure, whichever is later. I understand that I have the right to request a written summary of my rights under the FCRA. I further understand and consent that in connection with my employment that several investigative-consumer reports may be requested on me at any later time if I become employed by
Company Name
. The information is being obtained by Davis & Associates Professional Background Services, LLC. Any information or questions should be directed to the following address: Davis & Associates Professional Associates Services 1615 Downing Street, Denver Colorado 80218 Phone 303-861-1707 Fax 303-831-6043
Davis & Associates does not make hiring decisions and cannot answer questions relative to employment decisions.
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