BACKGROUND SCREENING AUTHORIZATION

Notice, Authorization, and release to Obtain Consumer Reports

Before completing the authorization form below, please take a moment to review this summary of your rights under the Fair Credit Reporting Act.

Background Screening Authorization
Purpose
  1. In connection with my application for volunteer work, I understand that an investigative consumer report may be requested. To obtain Consumer Reports and information concerning identity verification and criminal records, I understand that as directed by company policy and consistent with screening or consideration for volunteer work with Paws With A Cause, or its related corporate entities, you may be requesting information from public and private sources about my criminal history record and references.
  2. According to the Fair Credit Reporting Act, I am entitled to know if placement is denied because of information obtained by PAWS from a consumer-reporting agency. If so, I will be notified and given the name and address of the agency or the source which provided the information.
  3. I acknowledge that a telephone facsimile (FAX), electronic or photographic copy shall be valid as the original.
  4. I authorize, without reservation, any law enforcement agency, institution, information service bureau, reference or insurance company contacted by Paws With A Cause or related corporate entities, or its agent, to furnish the information described in Section 1 and waive any right to notice of such disclosure of that information and release. I agree to hold harmless from liability any person or organization that provides such information, as well as Paws With a Cause, its agents, officers, directors, employees and volunteers.

The following information is required by law enforcement agencies and other entities for positive identification purposes when checking public records. It is confidential and will not be used for any other purposes.

Home Address
Home Address
City
State/Province
Zip/Postal
Previous Address
Previous Address
City
State/Province
Zip/Postal
Sex