AUTHORIZATION

FOR FORMAL RELEASE OF INFORMATION

THIS INFORMATION IS BEING USED FOR BACKGROUND

PURPOSES ONLY


PERSONAL INFORMATION

Previous Address Within The Past Five Years


EMPLOYMENT HISTORY


EDUCATION

I hereby certify that l have carefully reviewed and approved the foregoing information supplied by me and that this information is true and correct to the best of my knowledge. In accordance with the Privacy Act, the Freedom of Information Act, and the Fair Credit Reporting Act. I expressly authorize Personnel Screening Services and any person associated with any Educational Institution, past or present Employer, any Law Enforcement Agency or Court, the Department of Motor Vehicles, all necessary Government and Private Agencies, Workers' Compensation, all Credit reporting Agencies to release tnis information to Personnel Screening Services for the purpose of being considered for employment. I hereby release Personnel Screening Services and ALL PERSONS from liablttty as a result of furnishing the foregoing information. l also authorize that a copy of this RELEASE be as valid as an original.


APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION

Check yes or no to each of the following questions. Explain when necessary.

EMPOLYMENT DESIRED

Check as many as necessary to describe the type of position you seek.

Education / Training

Previous Employment (all former employers, beginning with most recent)

References: Give below the names of 3 people not related to you, whom you have know at least one year.

Additional questions

The company may request consumer reports or investigative consumer reports in connection with your applications for employment or during the course of your employment (if any), with the company. Any information contained in such reports may be taken into consideration in evaluating your suitability for employment, promotion, reassignment or retention as an employee. Such reports, if obtained will be prepared by a consumer reporting agency and may contain information concerning your credit standing or worthiness, character, general reputation, personal characteristics, or mode of living. The types of reports that may be requested include, but are not limited to, credit reports, criminal records checks, court records checks, and/or summaries of educational and employment records and histories. The information contained in such reports may be obtained from public record sources or through personal interviews with your neighbors, friends, associates, current or former employers, or other personal acquaintances. I also understand that any offer of employment with Westcal Management will be contingent upon successful completion of all pre-employment requirements, including a background check and drug testing. I certify that the information contained in this application is true and correct and complete to the best of my knowledge and belief. I understand that any false statement, omission, or misrepresentation of facts in connection with this application can be cause for rejection of my application, or if I am employed, for my dismissal from employment. I also understand that I am required to abide by all rules and regulation of the Employer. I hereby understand and acknowledge that if I am employed, my employment relationship with the employer is of an "at-will" nature, which means that I may resign at any time and the Employer may discharge me at any time, with our without cause. It is further understood that this "at-will" Employment relationship may not be changed by any statement or conduct of any person, unless such change is specifically acknowledged in writing, sign by the president of the Employer. I acknowledge that no other promises, agreement or representations have been made contrary to this "at-will" employment agreement, and that this agreement, as acknowledged by my signature below is the full and complete agreement governing the Employer's and my rights and obligations concerning termination of my employment.

We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, sexual orientation, marital or veteran status, physical or mental disabilities, or any other legally protected status.


Employment Screening

CONSENT FOR INVESTIGATIVE REPORT FOR EMPLOYMENT SCREENING

I, the undersigned, give On-Site Manager, Inc., a credit-reporting agency, authorization to run an investigative. consumer screening report including but not limited to, a credit check, reference check, criminal check, rental history and employment history. This investigation is for employment purposes and shall not be shared with any other parties without my written permission. FCRA guidelines for employment screening can be found in Section 613 [15 U.S.C. ยง1681kJ].

Important information about your rights under the Fair Credit Reporting Act:

  • You must be told if information in your file has been used against you.
  • You have a right to know what is in your file, and this disclosure may be free. If an employer relies on a consumer credit report and takes adverse action against you, you are entitled to receive a copy of that report from the employer.
  • You have the right to ask for a credit score (there may be a fee for this service).
  • You have the right to dispute incomplete or inaccurate information. Consumer reporting agencies must correct or delete inaccurate, incomplete or unverifiable information.
  • Access to your file is limited. You must give your permission for reports to be furnished to employers
  • These reports are being processed by On-Site Manager, Inc., P.O. Box 1514, Los Altos, CA, 94023-1514, (877) 222-0384.
  • A summary of your rights under the Fair Credit Reporting Act is available by visiting or writing: (Para informacion en espanol, visite o escribe:) http://www.ftc.gov/credit Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Avenue N.W., Washington, D.C.20580

COPY WILL BE EMAILED TO APPLICANT AT TIME OF SUBMITTING THIS AUTHORIZATION FORM.