DISCLOSURE AND AUTHORIZATION FORM TO OBTAIN CONSUMER REPORTSPlease Read Carefully Before Signing the AuthorizationDISCLOSUREProSafety LLC or its affiliates (“the Company”) may request one or more consumer reports about you.For explanation purposes, these reports may include information on your driving records, creditworthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living.Such information may include, for example, credit information, criminal history reports, driving records, or personal interviews with your prior employers, neighbors, friends, or associates, or with others who may have knowledge concerning any such items of information.I. First Name Last Name acknowledge and agree that ProSafety LLC or its affiliates shall not be liable for any damages, losses, or liabilities, whether direct, indirect, incidental, special, consequential, or exemplary, arising out of or in connection with the consumer report request, even if ProSafety LLC or its affiliates has been advised of the possibility of such damages. This limitation of liability shall apply to the fullest extent permitted by law.I, First Name Last Name authorize ProSafety LLC or its affiliates to request one or more consumer reports for me per my request.