Fair Credit Reporting Act Disclosure Statement
TO BE READ AND SIGNED BY APPUCANT
I understand that, in accordance with the provisions of Section 604(b )(2)(A) of the Fair Credit Reporting Act, Public Law 91-508, as amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter I, of Public Law 104-208), I am being informed that reports verifying my previous employment, previous drug and alcohol test results, and my driving record will be obtained for employment purposes. These reports are required by Sections 382.413, 391.3, and 391.25 of the Federal Motor Carrier Safety Regulations
I understand that information I provide regarding current and/or previous employers may be used, and those employers will be contacted, for the purpose of investigating my safety performance history as required by 49CFR 391.23(d) and (e).
I have the right to review information provided by previous employers and request any errors corrected and resent to the prospective employer.
I have the right to submit a rebuttal statement to all alleged erroneous information, if the-previous employer and I cannot agree on the accuracy of the information.
I authorize my company to make inquiries of my personal, employment, and medical history and other related matters as may be necessary to arrive at an employment decision.
I hereby release all individuals from all liability in responding to inquiries and releasing information in connection with my application.