DISCLOSURE OF INTENT TO OBTAIN CONSUMER REPORTS

OR INVESTIGATIVE CONSUMER REPORTS 

For employment purposes, National Employment Screening and/or Absolute Background Search, Inc. may obtain consumer reports, or investigative consumer reports, in connection with your employment application or from time to time during employment in accordance with applicable law.  Consumer reports include record checks conducted by consumer reporting agencies and may include driving records,
criminal records, credit records, etc.  Investigative consumer reports include investigations (for example, reference checks) conducted by consumer reporting agencies through personal interviews (or through any means in California) on information as to character, general
reputation, personal characteristics, or mode of living.  You may make a written request for a summary of consumer rights and a disclosure
of the nature and scope of an investigation.  A disclosure of the nature and scope of such investigation is provided below.

DISCLOSURE OF NATURE AND SCOPE OF INVESTIGATION FOR INVESTIGATIVE CONSUMER REPORT
In the event we request an investigative consumer report in connection with your employment application, a consumer reporting agency will prepare an investigative consumer report based on the following investigation:
The agency will interview your former employers, business references, and/or personal references for information regarding prior employment, work experience and performance, reasons for employment termination, and information as to character, general reputation, personal characteristics, or mode of living.  The agency will also conduct a records check of driving, criminal, credit, education, degrees, professional licenses, and/ or certification records depending on the position.  Such a report, as well as any credit report, will be obtained from National Employment Screening/Absolute Background Search, Inc.  I have received a summary of my rights under the Fair Credit Reporting Act.
AUTHORIZATION
I authorize COMPANY and National Employment Screening/Absolute Background Search, Inc. to obtain consumer reports and/or investigative consumer reports regarding me from time to time for employment purposes. In compliance with the Fair Credit Reporting Act, as amended
by the Consumer Credit Reporting Reform Act of 2003, Absolute Background Search, Inc. needs my authorization to obtain such a report.

*This information will not be used for the purpose of discrimination. The Federal Age

Discrimination in Employ. Act of 1967 prohibits discrimination on the basis of age.

Signature:                                                                                  Date:                                                  

Print Name:                                                                                 Date of Birth:                                      

Address:                                                                                     Social Security #:                               

City                                                                                          State                                                  

Minnesota Applicants Only - - If you are in Minnesota and you desire a free copy of your consumer report, please place an “X” in the box.  FORMCHECKBOX