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Housekeeping Service Provider (Housekeeper)
You can earn on average from $20/hr. - $22/hr. (plus keep 100% of the tips!)
Cleanology® Housekeeping Personnel Service is a domestic referral agency that is registering experienced independent professional housekeepers seeking REGULAR or PART-TIME residential cleaning referrals throughout San Diego County.
Benefits of Cleanology® housekeeping job referrals:
- You can earn excellent compensation based on a fixed 50/50 percentage split of the total job costs
- Cleaning job referrals can be available 7 days a week, from San Ysidro to Oceanside
- Your choice of recurring job referrals (i.e. weekly; monthly), one-time cleanings (move-in/out cleanings; Spring cleaning; etc.) or BOTH!
- Ability to earn extra money for premium jobs or bookings on major holidays
- Be your own boss while working as an independent housekeeping service provider
- Register by yourself, or team up with an experienced housekeeping partner for more job referrals. In fact, you can work with a personal assistant as long as they are also registered with our domestic referral agency
- Because Cleanology® is strictly an administrative operation, we can help take care of advertising, scheduling, and billing, while you stay focused on performing your clients' housekeeping requests
Requirements:

** RESIDENTIAL HOUSEKEEPING SERVICES SKILLS and EXPERIENCE are a MUST!
You must be able to:
- Work independently
- Choose and control your individual workload and schedule
- Control your desired types of work and locations of work
- Complete a signed registration agreement (PROFESSIONAL REFERENCES AND BACKGROUND HISTORY WILL BE CHECKED).
- Provide your own personal:
  - cleaning supplies
  - equipment
  - vehicle
  - cell phone
** Hablamos Espanol, por favor mande un correo electronico a josey@CleanologySD.com para pedir su applicaccion en espanol.**

REGISTRATION APPLICATION
Name*

First NameLast Name
Date of Birth/Fecha de Nacimiento*
Email*
example@example.com
Phone Number*
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name
Emergency Contact Phone Number
** We want to confim your housekeeping experience. Please provide only your housekeeping experience. Do not leave any fields blank, enter NA if not applicable)

Employment History*

Rows	Most Recent	2	3
Employer
Position
Phone Number
Start Date
End Date
Reason For Leaving

Housekeeping References/ Referencias de limpieza (Minimum of 2 required/ Minimo de 2 referencias)*

Rows	1	2	3
Name
Phone Number
Email
Dates of Service
Type of Service

Availability*

Rows	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
All Day
Time Ranges

List the areas in San Diego County where you are available to accept housekeeping referrals.*
Basic HousecleaningMove In/OutsParty Clean UpLaundryWindow WashingFolding and putting away clothesOther
Are you afraid of or allergic to animals? (Specify):
Do you smoke?
Have you ever been convicted of a felony?
If so please explain
If yes, list dates and a complete explanation
I certify that all information provided on this application is correct. I authorize investigation of all statements contained in this application and for a background check to be completed. I understand that misrepresentation or omission of facts in this application may be cause for invalidation of my contract referral agreement with the agency.

* NOTE: YOU PROVIDE ALL SUPPLIES ,EQUIPMENT, TRANSPORTATION NEEDED TO PERFORM THESE SERVICES*
Signature*

Clear

Schedule of Fees

Client Rate(per hour)	% due domestic	Approx.(per hour)
$39.00	51%	$20.00
$44.50	50%	$22.50

Cleanology also offers flat rates to our recurring clients. This means that we calculate a price based off of the initial hourly service and the scope of work expected of you moving forward. We discuss the rate with you and get an approval on the suggested rate before offering it to the client. You will receive 50% of the set flat rate regardless of how long you take to complete the recurring services. Scheduling recurring clients in your schedule is completely optional. You can always decide to exclude yourselves from recurring clients and or services that may turn in to recurring services.

Rows	Confirm
Cleanology is a domestic referral agency and is not a cleaning or housekeeping company.
As an Independent Domestic Worker (IDW) you are not an employee of Cleanology.
Cleanology does not have the right to control the way you work.
Cleanology does not provide tools or supplies to complete a referral. You must provide these items yourself.
You can, and should, retain clients outside of the housekeeping referrals you receive through Cleanology.
You always have the option of picking the days, time and conditions under which you are willing to accept referrals.
You always have the option of declining an offered housekeeping referral.
If you are unable to maintain a scheduled job, you are responsible to contact the client for alternative arrangements
You will receive a fixed percentage of the total amount paid by the clients and are not paid by the hour.
Cleanology will receive a fixed percentage of the total amount paid by the client to the agency for services rendered.
You should alert Cleanology of payments made to you by a client to ensure correct billing processes
Neither the IDW nor Cleanology will receive a referral fee if the client refuses to pay for the work performed
As an independent domestic worker, and because you are not an employee of Cleanology, you will not have any amounts deducted or withheld from your wages for tax purposes, worker’s compensation insurance, medical insurance or unemployment insurance.
If a client gives you a key to gain access to their property, you are responsible for the key.
You are responsible for any damaged, lost or broken items belonging to the client.
You are responsible for resolving or remedying any issues or problems that may arise between you and a client.

This Professional Cleaner Registration Contract (“Contract”) is entered into in the City and County of San Diego, California, by and between Cleanology Housekeeping Personnel Service (“Cleanology; Agency”) and Housekeeper Name* (“Independent Cleaner”).RECITALS

Cleanology is a domestic services referral agency, whose business is to obtain contracts for housekeeping and domestic services in private residences, and referring said contracts to professional independent cleaners.

INDEPENDENT CLEANER is a professional independent housekeeper. Independent Cleaner is in the business of providing housecleaning and domestic services in private residences, and wishes to contract with Cleanology to obtain referrals of clients who desire housekeeping services from the Agency.

RELATIONSHIP BETWEEN THE PARTIES: Cleanology and Independent Cleaner expressly intend, agree and acknowledge that the relationship established by this Contract is that of a domestic services referral agency on the part of Cleanology, and that of a professional independent cleaner on the part of Independent Cleaner. The independent status of the cleaner means that the independent worker is an independent and not an employee of the Agency. Cleanology is not the employer of any Independent Cleaner it refers.

CLEANOLOGY AND INDEPENDENT CLEANER AGREE AS FOLLOWS:

1. Scope of Services: Cleanology will solicit and advertise for clients seeking to obtain domestic services, and Cleanology will supply Independent Cleaner with the names of clients seeking such services in a manner consistent with the "Employment Agency Employment Counseling and Job Listing Services Act". Independent Cleaner agrees to select, from a schedule of clients furnished by Cleanology, those clients for whom Independent Cleaner desires to perform services based upon the type of service desired, the times needed and the location of the clients.

2. Scheduling: Independent Cleaner is free to arrange his or her schedule as desired, and to make arrangements compatible with the scheduling needs of clients referred by Cleanology. Cleanology must be given timely notice of any changes to Independent Cleaner’s availability.

3. Freedom to Determine Conditions of Work: Independent Cleaner should inform Cleanology of any restrictions on hours, location, conditions or type of work that he or she will accept and is free to determine the conditions under which referrals from Cleanology will be accepted. Independent Cleaner may accept or reject any referral offered by Cleanology, and agrees to choose whether to accept or reject a particular offer as quickly as reasonably possible. Independent Cleaner agrees to give timely notice of any changes in availability, location, and type of work and/or conditions to Cleanology.

blank* (Independent Cleaner’s initials.).

4. Fees: Cleanology's current rate and fee schedules, together with the effective dates of any changes in rates or fee schedules are posted on the wall in Cleanology's office.

a)     Each client pays a fee to Cleanology that includes both Cleanology's referral fee and the Housekeeper’s job fee. Cleanology's fees are earned at the time payment from the client is due. Payments from clients are due at the time of service, unless Independent Cleaner is informed otherwise by Cleanology. All fees received are placed in Cleanology's Trust Account until payment is made to the Independent Cleaner.

b)     All client checks should be made payable to Cleanology’s Trust Account, and remitted to Cleanology by Independent Cleaner, unless otherwise instructed by Agency.

Of the fee paid by the client, 50% is due to the Independent Cleaner, and the remaining 50% is due to Cleanology as its referral fee.
* (Independent Cleaner’s initials.)

c)     Cleanology's referral fee may never exceed Independent Cleaner’s gross earnings for a particular job.

d)     Cleanology and Independent Cleaner shall settle accounts on at least a weekly basis, unless otherwise mutually agreed.

e)      Independent Cleaner is free to renegotiate with the client the amount proposed to be paid for the services performed.

f)     Independent Cleaner is not obligated to pay Cleanology's referral fee, and Cleanology is not obligated to pay Independent Cleaner, if the client fails or refuses to pay for the work performed.

g)     If the Independent Cleaner has a complaint or dispute about any fees, he or she agrees to submit that complaint or dispute in writing to Cleanology, within ten days of receipt of payment for those services rendered.

5. Non-exclusive Relationship: Independent Cleaner is free to enter into agreements with other referral agencies and to perform housekeeping or other work for clients not referred by Cleanology.

6. Equipment, Materials, Tools and Supplies: All cleaning equipment, materials, tools and supplies to be used and consumed in the performance of services provided by the Independent Cleaner shall be furnished by the Independent Cleaner or the client. Cleanology does not provide any equipment, materials, tools or supplies.

7. Control of Work: Independent Cleaner is solely responsible for the satisfactory performance of services to the client, and will receive no assistance, direction, training or control, either verbal or written from Cleanology. Independent Cleaner represents that he or she has all of the qualifications, skills, abilities and training necessary to perform all services to be rendered to the client in a professional manner, without the advice, control, direction or supervision of Cleanology.

8. No Training Provided: Independent Cleaner understands and acknowledges that no training is provided by Cleanology in relation to the methods, details or means of performing housekeeping services. Independent Cleaner represents that he or she has all necessary training and experience to perform those services, and that if questions arise as to the method or means appropriate for a particular client, Independent Cleaner will ask the client for clarification. Cleanology may however offer a voluntary orientation session to acquaint Independent Cleaner with Cleanology's administrative and operating procedures and related matters.

9. Independent Status: Independent Cleaner is an independent professional, and not an employee of Cleanology. Cleanology does not provide Independent Cleaner with any benefits provided to employees, including without limitation Social Security or Workers’ Compensation Benefits, Unemployment Insurance, State Disability Insurance, tax withholding or any other employee benefits.



10. Legal Status: Independent Cleaner shall provide to Cleanology verification of worker's legal status or authorization to work in accordance with procedures established under federal law prior to being provided with referrals services from the Cleanology.

* (Independent Cleaner’s initials.).

11. Licenses and Permits: Independent Cleaner is solely responsible for any and all business licenses and permits required by state or local law, ordinance or regulation, for conducting their services to be performed. Independent Cleaner agrees to indemnify Cleanology from and against any claims, losses, costs, fees, liabilities, damages or injuries arising out of Independent Cleaner’s failure to obtain any necessary license or permit.
* (Independent Cleaner’s initials.).

12. Business Expenses: As between Cleanology and Independent Cleaner, Independent Cleaner is responsible for any business expenses incurred in connection with the performance of his or her housekeeping services, including but not limited to all expenses for supplies, materials, equipment, tools and transportation. Independent Cleaner is free to negotiate responsibility for these expenses with the client.

13. Taxes: Independent Cleaner shall pay, when and as due at Independent Cleaner's expense and in Independent Cleaner's name, employment, state and federal taxes. Cleanology will not withhold income or employment taxes, or any other withholdings required of an employer. Independent Cleaner is responsible to pay, when and as due, any and all taxes incurred as a result of Independent Cleaner’s earnings. As required by law, Cleanology will report Independent Cleaner’s earnings on a Federal form 1099 if yearly Independent Cleaner's earnings are $600.00 or greater.  Cleanology is not liable, and Independent Cleaner agrees to indemnify Cleanology from and against any claims, losses, costs, fees, liabilities, damages or injuries arising out of Independent Cleaner’s failure to pay any required taxes or withholdings.
* (Independent Cleaner’s initials.).

14. Inability to Provide Service: If Independent Cleaner needs to change a previously agreed upon work date or time, it is Independent Cleaner’s responsibility to notify the client at the earliest possible time, and to attempt to arrange a reschedule date or time directly with the client. If Independent Cleaner and client are unable to arrange a reschedule date or time, and should client desire, Cleanology will attempt to refer another qualified cleaner to fulfill the obligation to the client. Independent Cleaner will notify Agency promptly of any changes, and whether or not client wishes Cleanology to attempt to reschedule another cleaner.



15. Termination: The relationship between Independent Cleaner and a client may be terminated only by one of those parties, and not by Cleanology. However, Cleanology may decline to make additional referrals to an Independent Cleaner, and Independent Cleaner may decline to accept any client referrals from Cleanology.  Either Cleanology or Independent Cleaner may terminate this Contract for any reason, upon ten (10) days written notice. The clients referred by Cleanology to Independent Cleaner will remain Cleanology's clients upon termination of the client’s relationship with Independent Cleaner, or upon Independent Cleaner’s disassociation from Cleanology.

16. No Solicitation of Clients: Independent Cleaner agrees not to solicit any of the clients referred to him or her by Cleanology for his or her own benefit, or that of any other person or entity, during Independent Cleaner’s association with Cleanology, and for nine months after that association ends. Should Independent Cleaner wish to establish a private working relationship with a client referred by Cleanology, and the client wishes to enter into such a relationship, Independent Cleaner agrees to pay the sum of $1,000.00 to Cleanology for each such client. Independent Cleaner also agrees to pay Cleanology's reasonable attorney’s fees and costs incurred in enforcing this provision, if necessary.
* (Independent Cleaner’s initials.).

17. Resolution of Disputes: Cleanology may contact the client to determine whether they are satisfied with Cleanology's referral service. If Cleanology receives a complaint from a client about Independent Cleaner’s performance, Cleanology agrees to promptly inform Independent Cleaner of the complaint, so that Independent Cleaner may resolve it directly with the client. As between Cleanology and Independent Cleaner, Independent Cleaner is solely responsible for any damage or loss caused to client or client’s property. In the event a client complains about the quality of service rendered, breakage, theft, or any other problem occurring on the premises where Independent Cleaner works for a client, it is Independent Cleaner’s sole responsibility to resolve the situation or dispute with the client as soon as possible.

* (Independent Cleaner’s initials.).

18. Assumption of Risk and Fee Obligation: Independent Cleaner acknowledges that as an independent professional, he or she assumes risks associated with bad debts, fraudulent or cancelled checks or contested payments by the client. If a client refuses to pay for all or part of the services performed, Independent Cleaner is not obligated to pay Cleanology's referral fee, and Cleanology is not obligated to pay Independent Cleaner for that work performed. Cleanology is not obligated to collect fees claimed by Independent Cleaner to be due from a client and owed to the Independent Cleaner. If Cleanology does collect outstanding fees due, Independent Cleaner will be paid the agreed upon percentage of those fees collected. If a referral is terminated, Agency fee may not exceed Domestic's gross earnings in that engagement.



19. Proprietary and Trade Secret Information: Independent Cleaner agrees and acknowledges that the names, addresses and other confidential information about clients referred by Cleanology, which Cleanology communicated to Independent Cleaner, or which Independent Cleaner learned through its association with Cleanology, is confidential, proprietary and/or trade secret information of Cleanology. All client information and any other proprietary or trade secret information of Cleanology must be returned to Cleanology upon Independent Cleaner’s disassociation from Cleanology, termination of this Contract, or upon Cleanology's request. Any unauthorized use or disclosure of such information is prohibited by the Uniform Trade Secrets Act (Civil Code sections 3426 - 3426.11) and California’s Unfair Competition Laws (Business and Professions Code sections 17200 - 17209), and will subject Independent Cleaner and any other involved party to liability. This provision is for the privacy and protection of our clients, as well as the preservation of proprietary and trade secret information.

20. Indemnification Clause: Independent Cleaner agrees to indemnify, defend and hold Cleanology harmless from and against any and all claims, demands, losses, costs, expenses, obligations, fees and costs that Cleanology may incur or suffer as a result of, or in relation to, any breach of this Contract, or failure to perform, by Independent Cleaner.

21. Records: Cleanology will maintain records of referrals between Cleanology and Independent Cleaner for a reasonable period of time.

22. Right to refund: (This provision applies only when Independent Cleaner has paid an upfront fee to Cleanology)

“If you pay all or any portion of a fee and fail to accept employment, the employment agency shall, upon your request, return the amount paid to you within 48 hours after your request for a refund.

“If you leave employment for just cause or are discharged for reasons other than misconduct connected with your work within 90 days from the starting date of employment, the agency shall reduce your fee to that payable for temporary employment and shall refund any excess paid within 10 days of your request for a refund.

“No fee larger than that for temporary employment may be charged to you for employment lasting 90 days or less unless the agency’s fee schedules, contracts, and agreements provide for a further charge if you leave employment without just cause or are discharged for misconduct in connection with your work.

“If any refund due is not made within the time limits set forth above, the employment agency shall pay you an additional sum equal to the amount of the refund.”

* (Independent Cleaner’s initials.).

23. Term of Referral Agreement:

A. This Referral Agreement shall become effective on the date of its execution by both parties.

B. This Referral Agreement shall terminate:

1. Upon ten (10) calendar days prior written notice from Independent Cleaner to Cleanology. Independent Cleaner shall perform service for all accepted contracts during this 10-day period.

2. Upon the death of Independent Cleaner, or on the dissolution or sale of the Cleanology.

                       3. Upon a material default by Independent Cleaner in the performance of this contract                                      agreement or a               material breach of any of its provisions.               "Material breach or default" of this Referral Agreement shall include, but not be limited to, discharge of Independent Cleaner by client for just cause, and failure to remit Cleanology 's fee within the time agreed upon, and   Independent Cleaner understands that only the client has the right to terminate the Independent Cleaner if the services provided were not satisfactory. Termination for material       breach or default shall be effective immediately upon personal               delivery of written notification, or (5) days from the date of mailing of the notice, whichever date occurs first.

                       4. All clients’ lists, information and keys due to Cleanology from Independent Cleaner at the                     time of termination of contract shall be returned.

If any part of this Agreement is held by a court to be void or unenforceable, the remaining provisions will not be affected, and will continue in force. This is the complete agreement between the Cleanology and the Independent Cleaner. Any change to this Agreement must be in writing and signed by both parties. This Agreement shall be interpreted according to California law. Independent Cleaner has thoroughly read and fully understands this Referral Agreement and agrees to be fully bound by all its terms, provisions and conditions.

Whole Name*

Independent Cleaner

Type full address with city, state and zip*

Full Address

Best # to reach you*

Phone Number
Date

MonthDayYear
Date
Signature*

Clear

BACKGROUND CHECK DISCLOSURE DOCUMENT

Cleanology Housekeeping Personnel Service (the “Company”) may order a “consumer report” (a background report) about you from a consumer reporting agency (CRA) in connection with your employment or your application for employment (including independent contractor or volunteer assignments, as applicable).

The consumer report may include information about your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living. The Company may not order a consumer report about you without your written authorization (which you may provide through a separate document called the Authorization for Background Checks).

The Company may also request an “investigative consumer report” on you. An “investigative consumer report” is a type of consumer report that involves personal interviews conducted for the Company by the CRA, most commonly with an individual’s prior employers or references.

You have the right to request more information about the nature and scope of any investigative consumer report obtained on you by contacting the Company.

Additionally, the Fair Credit Reporting Act gives you specific rights in dealing with CRAs. You will find these rights summarized in a separate document titled A Summary of Your Rights Under the Fair Credit Reporting Act.

THE REMAINDER OF THIS DOCUMENT IS INTENTIONALLY LEFT BLANK.

PLEASE PROCEED TO THE NEXT DOCUMENT: “A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT”

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Para informacion en espanol, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

·         You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.

·         You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:

o   a person has taken adverse action against you because of information in your credit report;

o   you are the victim of identity theft and place a fraud alert in your file;

o   your file contains inaccurate information as a result of fraud;

o   you are on public assistance;

o   you are unemployed but expect to apply for employment within 60 days.

In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.

·         You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.

·         You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.

·         Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.

·         Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.

·         Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need -- usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.

·         You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.

·         You may limit “prescreened” offers of credit and insurance you get based on information in your credit report. Unsolicited “prescreened” offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-567-8688.

·         The following FCRA right applies with respect to nationwide consumer reporting agencies:

CONSUMERS HAVE THE RIGHT TO OBTAIN A SECURITY FREEZE

You have a right to place a “security freeze” on your credit report, which will prohibit a consumer reporting agency from releasing information in your credit report without your express authorization. The security freeze is designed to prevent credit, loans, and services from being approved in your name without your consent. However, you should be aware that using a security freeze to take control over who gets access to the personal and financial information in your credit report may delay, interfere with, or prohibit the timely approval of any subsequent request or application you make regarding a new loan, credit, mortgage, or any other account involving the extension of credit. As an alternative to a security freeze, you have the right to place an initial or extended fraud alert on your credit file at no cost. An initial fraud alert is a 1-year alert that is placed on a consumer’s credit file. Upon seeing a fraud alert display on a consumer’s credit file, a business is required to take steps to verify the consumer’s identity before extending new credit. If you are a victim of identity theft, you are entitled to an extended fraud alert, which is a fraud alert lasting 7 years.

A security freeze does not apply to a person or entity, or its affiliates, or collection agencies acting on behalf of the person or entity, with which you have an existing account that requests information in your credit report for the purposes of reviewing or collecting the account. Reviewing the account includes activities related to account maintenance, monitoring, credit line increases, and account upgrades and enhancements.

·         You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.

·         Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.

States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. For information about your federal rights, contact:

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TYPE OF BUSINESS:
CONTACT:
1.a. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates.

b. Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the CFPB:

a.        Consumer Financial Protection Bureau

1700 G Street, N.W.

Washington, DC 20552

b.        Federal Trade Commission: Consumer Response Center

600 Pennsylvania Avenue, N.W.

Washington, DC 20580

(877) 382-4357
2. To the extent not included in item 1 above:

a.        National banks, federal savings associations, and federal branches and federal agencies of foreign banks

b.        State member banks, branches and agencies of foreign banks (other than federal branches, federal agencies, and Insured State Branches of Foreign Banks), commercial lending companies owned or controlled by foreign banks, and organizations operating under section 25 or 25A of the Federal Reserve Act

c.        Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associations

d.        Federal Credit Unions

a.        Office of the Comptroller of the Currency

Customer Assistance Group

1301 McKinney Street, Suite 3450

       Houston, TX 77010-9050

b.        Federal Reserve Consumer Help Center

P.O. Box 1200

Minneapolis, MN 55480

c.        FDIC Consumer Response Center

1100 Walnut Street, Box # 11

Kansas City, MO 64106

d.        National Credit Union Administration

Office of Consumer Financial Protection (OCFP)

Division of Consumer Compliance Policy and Outreach

1775 Duke Street

Alexandria, VA 22314
3. Air carriers
Asst. General Counsel for Aviation Enforcement & Proceedings

Aviation Consumer Protection Division/Department of Transportation

1200 New Jersey Avenue, S.E.,Washington, DC 20590
4. Creditors Subject to the Surface Transportation Board
Office of Proceedings, Surface Transportation Board

Department of Transportation

395 E Street, S.W.Washington, DC 20423
5. Creditors Subject to the Packers and Stockyards Act, 1921
Nearest Packers and Stockyards Administration area supervisor
6. Small Business Investment Companies
Associate Deputy Administrator for Capital Access

United States Small Business Administration

409 Third Street, S.W., Suite 8200

Washington, DC 20416
7. Brokers and Dealers


Securities and Exchange Commission

100 F Street, N.E.Washington, DC 20549
8. Federal Land Banks, Federal Land Bank Associations, Federal Intermediate Credit Banks, and Production Credit Associations

Farm Credit Administration

1501 Farm Credit Drive

McLean, VA 22102-5090
9. Retailers, Finance Companies, and All Other Creditors Not Listed Above
Federal Trade Commission: Consumer Response Center,600 Pennsylvania Avenue, N.W.Washington, DC 20580

(877) 382-4357

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3

CALIFORNIA DISCLOSURE DOCUMENT

Cleanology Housekeeping Personnel Service (the “Company”) may order an “investigative consumer report” (a background report) on you in connection with your employment or application for employment (including independent contractor or volunteer assignments, as applicable). The investigative consumer report may contain information about your character, general reputation, personal characteristics, and mode of living. As allowed by law, such reports may contain the following information pertaining to you: credit history; public records; a Social Security number verification; driving records; military service; credentials/certifications; and verification of prior employment and education. The Company may not order an investigative consumer report about you without your written authorization (which you may provide through a separate document called the Authorization for Background Checks).

The agency conducting the investigation and preparing the background report for the Company is ADP Screening and Selection Services, Inc. (ADP SASS), at 301 Remington Street, Fort Collins, CO, 80524; phone number 800-367-5933; website, http://www.adpselect.com. This website contains information concerning ADP SASS’ privacy practices.

A Summary of Your Rights Under the Provisions of California Civil Code Section 1786.22

(a) An investigative consumer reporting agency shall supply files and information required under Section 1786.10 during normal business hours and on reasonable notice.

(b) Files maintained on a consumer shall be made available for the consumer's visual inspection, as follows:

(1) In person, if he appears in person and furnishes proper identification. A copy of his file shall also be available to the consumer for a fee not to exceed the actual costs of duplication services provided.

(2) By certified mail, if he makes a written request, with proper identification, for copies to be sent to a specified addressee. Investigative consumer reporting agencies complying with requests for certified mailings under this section shall not be liable for disclosures to third parties caused by mishandling of mail after such mailings leave the investigative consumer reporting agencies.

(3) A summary of all information contained in files on a consumer and required to be provided by Section 1786.10 shall be provided by telephone, if the consumer has made a written request, with proper identification for telephone disclosure, and the toll charge, if any, for the telephone call is prepaid by or charged directly to the consumer.

(c) The term "proper identification" as used in subdivision (b) shall mean that information generally deemed sufficient to identify a person. Such information includes documents such as a valid driver’s license, social security account number, military identification card, and credit cards. Only if the consumer is unable to reasonably identify himself with the information described above, may an investigative consumer reporting agency require additional information concerning the consumer's employment and personal or family history in order to verify his identity.

(d) The investigative consumer reporting agency shall provide trained personnel to explain to the consumer any information furnished him pursuant to Section 1786.10.

(e) The investigative consumer reporting agency shall provide a written explanation of any coded information contained in files maintained on a consumer. This written explanation shall be distributed whenever a file is provided to a consumer for visual inspection as required under Section 1786.22.

(f) The consumer shall be permitted to be accompanied by one other person of his choosing, who shall furnish reasonable identification. An investigative consumer reporting agency may require the consumer to furnish a written statement granting permission to the consumer reporting agency to discuss the consumer's file in such person's presence.

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ADDITIONAL BACKGROUND CHECK DISCLOSURES

ADVERSE ACTION AND DISPUTES NOTICE: The consumer reporting agency ADP Screening and Selection Services, Inc. (ADP SASS) will prepare the background report for Cleanology Housekeeping Personnel Service (the “Company”). ADP SASS is located at 301 Remington Street, Fort Collins, CO, 80524, and can be reached by phone at 800-367-5933 or at www.adpselect.com. ADP SASS does not make any decisions to take adverse action. If the Company makes a decision to take adverse action, ADP SASS will not be able to provide specific reasons why the adverse action was taken.

You have the right to obtain a free copy of a consumer report on you from the consumer reporting agency which prepared your background report, under various circumstances, including but not limited to where you receive notice that an adverse action has been taken toward you based on the consumer report. In that instance, you have the right to a free copy of the report provided that you make the request within 60 days of the date that you received the notice of adverse action. You have the right to dispute, with a consumer reporting agency, the accuracy or completeness of any information in a consumer report furnished by the agency.

If you live or work for the Company in any of the states below, note the following:

CALIFORNIA: If the Company obtains credit history information on you, it will be because you have applied for a position: (a) that is managerial; (b) that is in the state Department of Justice; (c) that is in law enforcement or is that of a sworn peace officer; (d) for which a credit history is required by law; (d) that involves access to sensitive personal information of a customer, employee, or employer that is not customarily provided in a retail transaction; (e) that involves access to trade secrets; or (f) that involves regular access to cash during the work day totaling $10,000 or more.

BACKGROUND CHECK DISCLOSURE DOCUMENT
I authorize Cleanology Housekeeping Personnel Service (the “Company”) to obtain a consumer report(s) (or background report(s)) on me, including any investigative consumer reports. I also agree that a copy of this form is valid like the signed original.

The consumer reporting agency (CRA) ADP Screening and Selection Services, Inc. (ADP SASS) will prepare the background report for the Company. ADP SASS is located at 301 Remington Street, Fort Collins, CO, 80524, and can be reached by phone at 800-367-5933 or at www.adpselect.com.

I understand that, as allowed by applicable law, the Company may rely on this authorization to order additional background reports, including investigative consumer reports, (1) during my employment or time as a volunteer or independent contractor, as applicable and (2) from any CRA other than ADP SASS without asking me for my authorization again. I understand the Company may order background report(s) under my legal name and any other names I may have used.

I also authorize the following persons, agencies, and entities to disclose to ADP SASS and its agents all information about or concerning me, as allowed by law, including but not limited to: my past or present employers; learning institutions, including colleges and universities; law enforcement and all other federal, state and local agencies; federal, state and local courts; the military; credit bureaus; testing facilities; motor vehicle records agencies; if applicable, worker’s compensation injuries; all other private and public sector repositories of information; and any other person, organization, or agency with any information about or concerning me. As allowed by law, such disclosures may contain the following information pertaining to you: credit history; public records; a Social Security number verification; driving records; military service; credentials/certifications; and verification of prior employment and education.
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Housekeeping Service Provider (Housekeeper)

You can earn on average from $20/hr. - $22/hr. (plus keep 100% of the tips!)

Benefits of Cleanology® housekeeping job referrals:

Requirements:

REGISTRATION APPLICATION

These questions are to ensure you have professional housecleaning skills, knowledge and experience. This is not a quiz, nor is it training on the part of “Cleanology”. Please “select" or “write in” your answers

BACKGROUND CHECK DISCLOSURE DOCUMENT