I understand that you intend to make an independent investigation of my background which may include references, character, past employment, education, credit and consumer information, driving history, criminal or police records, or insurance claim records, including those maintained by both public and private organizations and all public records for the purpose of confirming the information contained on my application and/or obtaining other information which may be material to my qualifications for employment (a "Background Investigation").
I hereby authorize you, as part of the application process, and from time to time during my employment, to conduct a background investigation, which may include a consumer report and/or a motor vehicle report. I authorize the release of all such information to you. I also agree to show my state ID, driving license, proof of auto insurance, and/or auto registration any time at the employer's request.
I release, without reservation, you and any person or entity which provides information pursuant to this authorization, from any and all liabilities, claims or causes of action in regards to the information obtained from any and all of the above reference sources used. I acknowledge that this is a stand-alone consumer notification informing me that a report will be requested and that the information obtained shall be used solely for the purpose of evaluating me for employment, promotion, reassignment, or retention as an employee.
The information on this form is required for identification purposes only. We are an Equal Opportunity Employer and do not discriminate on the basis of sex, race, color, religion, creed, national origin, veteran status, age, disability, or on the basis of any other classification or characteristic protected by federal, state, or local law. In addition, this form is subject to revision without notice in the event of a change in federal, state, or local law.