Disclosure: The purpose of this Notice and Authorization is to inform you that Sendero Drilling Company, LLC. (the "Company") conducts background record checks, including a criminal record check, on (i) all applicants who are extended conditional job offers, and (ii) employees for the purpose of evaluating retention, promotion, reassignment or other employment-related decisions (collectively, the "employment purposes"). The background record checks are considered “consumer reports” under the federal Fair Credit Reporting Act (the “FCRA”). The Company may request consumer reports from consumer reporting agencies, including, but not limited to, the following:
Applicant Insight Inc.,
5396 School Rd.
New Port Richey, FL 34652
The Company may use the information in these reports for hiring or other employment purposes. In other words, the information disclosed by the credit reporting agency may be used by the Company to make employment decisions. These reports may include the following types of information about you: names and dates of previous employers, reason for termination of employment, work experience, academic history, professional credentials, drug use, driving record, workers’ compensation claims, credit history, criminal record, and other information regarding your character, general reputation, personal characteristics and/or mode of living.
The Company requires, as a condition of employment, that all applicants who receive a conditional job offer consent to the background record checks (i.e., consumer reports) and provide certain identifying information to facilitate the background record checks. Failure to consent to the background record checks will result in ineligibility for employment or termination of employment.
You have the right to make a written request, within a reasonable period of time after receiving this Notice and Authorization, for additional disclosures about the nature and scope of any consumer reports obtained by the Company. The agencies may be contacted by mail or by phone at the addresses and phone numbers listed above.
If you are not hired (or if an adverse employment action is taken against you), either in whole or in part based on information contained in a consumer report, the Company will notify you and provide you with the name, address, and telephone number of the consumer reporting agency who prepared the consumer report. Before taking any adverse action, the Company will provide you a copy of the consumer report and a statement of your consumer rights under the FCRA.
Authorization and Consent: I hereby authorize Sendero Drilling Company LLC. to obtain consumer reports and use information in such consumer reports for employment purposes. I further authorize the agencies listed above, or any other agency, and any party or agency contacted by the agencies listed above, or any other agency, to furnish consumer reports on me, which may include, among other information, the information described above for use in conducting a criminal record check, as part of its background record check. I further authorize the agencies listed above, or any other agency, to disclose all information obtained to Sendero Drilling Company. for the purpose of making a determination as to my eligibility for employment or any other employment purpose. I further authorize any person, organization, governmental authority or other party to release and disclose information and cooperate in the obtaining and producing of consumer reports on me for employment purposes.
If I am hired, this Notice and Authorization shall remain valid and serve as an ongoing authorization for the Company and its agents to obtain consumer reports on me for employment purposes at any time during my employment. I acknowledge and agree that a signed facsimile or photocopy of this Notice and Authorization may be accepted with the same authority as the original.
I release the Company and its officers, employees, independent contractors and agents from any and all claims, actions, and liabilities arising from or relating to the Company conducting this background record check and obtaining and considering information about me through a consumer report. This release includes, but is not limited to, liability based on negligence. I understand that this Notice and Authorization does not limit my rights, if any, under the FCRA.
My signature below acknowledges receipt of this Notice and Authorization for consumer reports. I hereby certify that I have read and fully understand this Notice and Authorization. I hereby certify that prior to signing, I was given an opportunity to ask questions and to have those questions answered to my satisfaction. I further certify that I executed this Notice and Authorization voluntarily and with the knowledge and understanding that the information being released could affect whether I am hired, and, if hired, my retention, promotion, reassignment or other employment-related decisions. I understand that the additional information below that is furnished by me will be used in conducting the background record check. My signature below authorizes the Company to obtain consumer reports on me: