DISCLOSURE UNDER FAIR CREDIT REPORTING ACT AND CONSENT TO PROCUREMENT OF CONSUMER REPORT FOR EMPLOYMENT PURPOSES

The undersigned hereby authorizes the Goodwill Industries of Wayne and Holmes Counties or its insurance agency, Whitaker-Myers Insurance Agency Inc., or its assigns, to obtain copies of consumer reports, including a motor vehicle report, pertaining to me for employment purposes, and for use in rating and/or underwriting insurance for which the above-named employer may apply, and any renewal thereof. I understand that in obtaining such consumer reports, a consumer reporting agency may be

used and I do hereby authorize such use.