Authorization for Background Check

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Assertions & Authorizations

Upon request, you will be informed whether or not a consumer report was requested by the Employer, and if such report was requested, informed of the name and address of the consumer reporting agency that furnished the report. You have the right to inspect and receive a copy of any investigative consumer report requested by the Employer by contacting the consumer reporting agency identified above directly. By checking this box and signing below, you acknowledge receipt of Article 23-A of the New York Correction Law.

By checking this box, you acknowledge and authorize the Employer to provide any notices required by federal, state or local law to you at the address(es) and/or email address(es) you provided to the Employer.

Please check this box if you would like to receive a copy of a consumer report if one is obtained by the Employer.

By checking this box, you acknowledge that you also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act.

I acknowledge receipt of the separate document entitled DISCLOSURE REGARDING BACKGROUND INVESTIGATION and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and certify that I have read and understand both of those documents. I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” by Set Free Monterey Bay (“Employer”) at any time after receipt of this authorization and throughout my employment, if applicable.

To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, insurance company, or motor vehicle department to furnish any and all background information, including criminal history, employment, education, and driving records (Motor Vehicle Reports/MVRs), requested by Verified First, 1550 South Tech Lane, Suite 200, Meridian, Idaho 83642; Tel. # 1-888-670-9564; www.VerifiedFirst.com and/or Employer. I agree that a facsimile (“fax”), electronic, or photographic copy of this Authorization shall be as valid as the original.

I agree to submit the $45 application fee through the SFMB website through the GIVE button, which will cover the cost of my background check. Other forms of payment are also accepted: checks made out to Set Free Monterey Bay. When paying $45 through our website via PayPal (please put “Background Check” in the memo/note line)

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