NOTICE REGARDING BACKGROUND INVESTIGATION
This authorization and consent for release of personal information acknowledges that Muirhead Trucking, Inc hereafter referred to as "Company" and/or its agent, Investigative Concepts, Inc., may now, or at any time I am assigned to or am employed by this Company, run a “consumer report” and/or an “investigative consumer report”. These investigations whether the records are of a public, private or confidential nature, may include, but are not limited to, information about your character, general reputation, personal characteristics and searches of educational institutions attended to obtain an academic record, state driving records, records of previous employment, including work history, efficiency ratings, complaints and grievances filed by or against me; records and recollections of attorney-at-law or of other counsel, whether representing me or any other person (in either a civil or criminal case in which I have been involved); records from the U.S. Veterans' Administration; and criminal history information on file in local, state or federal agencies. After receiving an offer of employment, I understand that a workers' compensation report may be obtained from either the Department of Labor, National Personnel Records, the Industrial Commission or similar agencies under the provisions of the Fair Credit Reporting Act 15, USC section 1681 et seq. I further authorize, in accordance to DOT Regulations, my DOT regulated drug and alcohol testing records, including but not limited to, a limited query of FMCSA Commercial Driver’s License Drug and Alcohol Clearinghouse and information directly from my previous employers regarding any positive drug test, any refusal to be tested and any other violations of the DOT regulations, occurring in the previous 3 years. I authorize all records to be released to Investigative Concepts, Inc.
ACKNOWLEDGMENT AND AUTHORIZATION
I acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and certify that I have read and understand both documents. I hereby authorize and consent to the obtaining of a “Investigative Consumer Report” and/or a “Consumer Report” at any time after receipt of this authorization. In addition, I release and discharge the Company and its agent/associates to the full extent permitted by law from any claims, damages, losses, liabilities, costs expenses or any other charge or complaint filed with any agency arising from retrieving and reporting this information. I understand that I may request a copy of the report from Investigative Concepts, Inc, at P.O. Box 471832 Tulsa, OK or telephone number 918-286-7059.
I understand If I am applying for employment in Oklahoma or Minnesota I may request a copy of Consumer Report.
I understand If I am applying for employment in California I may request a copy of Consumer Report.
Under Section 1786.16(a)(2)(B)(vi) of CA Civil Code, you are notified that Investigative Concepts, Inc. privacy practices can be found at www.investigativeconcepts.net. Under Section 1786.20.5 of the CA Civil Code and Section 1024.5 of the CA Labor Code, you are notified that a credit report may be ordered if you are applying for a position involving access to confidential or proprietary information.
I understand that if I am applying for employment in New York, that I have the right to receive a copy of Article 23-A of the New York Correction Law.
I understand that if the report is provided to an employer in the State of Washington, that I can contact the State of Washington Attorney General, Consumer Protection Division, 800 5th Ave, Ste. 2000, Seattle, Washington 98104-3188, (206) 464-7744, for more information regarding my rights under Washington State law.