Background Auth for Contractor / Driver / Helper

DISCLOSURE AND AUTHORIZATION REGARDING BACKGROUND INVESTIGATION FOR CONTRACTING PURPOSES

Disclosure

RAPID RESPONSE, INC. (the "Company") may request from a consumer reporting agency and for contract-related purposes, a "consumer report(s)" (commonly known as "background reports") containing background information about you in connection with your contract (including independent contractor or volunteer assignments, as applicable

The background report(s) may contain information concerning your character, general reputation, personal characteristics. The types of background information that may be obtained include, but are not limited to: criminal history; litigation history; motor vehicle record and accident history; social security number verification; address and alias history; professional licensing, credential and certification checks; drug/alcohol testing results and history; military service; and other information.

Authorization

I hereby authorize Company to obtain the consumer reports described above about me.
Contractor You Are Applying To:*
Select:*

DriverHelper
Applicant Signature*

Clear
Date*

MonthDayYear
Date
Printed Name*
Date of Birth*

MonthDayYear
Date
Social Security #*
Driver's License #*
State*
Expires*
Address*

Address

Street Address Line 2

City/State/ZipState / Province

Postal / Zip Code
Phone*
Driver’s License*

***Please provide a copy of your driver’s license with this signed form
Cancelof
Medical Card (Optional)

***Please provide a copy of your medical card with this signed form
Cancelof
Medical Card Expiration Date

MonthDayYear
Date
You can check out the details and general instructions below:
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