Dog Adventures Northwest runs a criminal background check and DMV check for all Independent Contractors. All Contractors are asked to read the disclosure and sign the authorization before signing the Independent Contractor Agreement.
FAIR CREDIT REPORTING ACT DISCLOSURE
In the course of considering your application for work at Dog Adventures Northwest, LLC (“Company”) and/or its agents, including a consumer reporting agency, may wish to obtain and use a “consumer report” and/or an “investigative consumer report” from a “consumer reporting agency” for hiring purposes.
These terms are defined in the Fair Credit Reporting Act (“FCRA”) which applies to you. As an applicant or current employee or contractor, you are a “consumer” with rights under the FCRA.
A “consumer report” is any written, oral, or other communication of any information by a “consumer reporting agency” bearing on a consumer’s creditworthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living which is used or collected for the purpose of serving as a factor in establishing the consumer’s eligibility for employment or independent contractor service.
An “investigative consumer report” is a consumer report in which the information about your character, general reputation, personal characteristics and mode of living is obtained in whole or in part through personal interviews with individuals who may have knowledge concerning such information.
A “consumer reporting agency” means any person which, for monetary fees, dues, or on a cooperative nonprofit basis, regularly engages in whole or in part in the practice of assembling or evaluating consumer credit information or other information on consumers for the purpose of furnishing consumer reports to third parties, and which uses any means or facility of interstate commerce for the purpose of preparing or furnishing consumer reports.
If the Company obtains a “consumer report” about you, and if the Company considers any information in the “consumer report” when making a decision about whether to enter an employment or contract relationship with you that directly and adversely affects you, you will be provided with a copy of the “consumer report” before the decision is finalized. You also may contact the Consumer Financial Protection Bureau about your rights under FCRA as a “consumer” with regard to “consumer reports” and “consumer reporting agencies.” Please also see “A Summary of Your Rights Under the Fair Credit Reporting Act.”
The Company does not request, and will not consider, information pertaining to your credit history unless that information is substantially related to the position for which your application is being considered. If applicable, you will be specifically informed of the Company’s intent to obtain and consider that information.
I ACKNOWLEDGE THAT I HAVE RECEIVED AND READ THIS “FAIR CREDIT REPORTING ACT DISCLOSURE.”
Applicant Signature
Applicant Name (Printed)
Date
AUTHORIZATION TO RELEASE INFORMATION AND RECORDS
I hereby voluntarily grant Dog Adventures Northwest, LLC (“Company”) and its authorized representatives at any time during my application for work as an independent contractor, employment or in connection with my continued employment, promotion, or reassignment, the authority to conduct an inquiry into my criminal history and motor vehicle records. These inquiries may include personal conversations with persons possessing knowledge relevant to these categories. I understand that as part of this inquiry, my criminal record and driving record, and consumer report may be reviewed by the Company. These inquiries will be conducted, and the reports will be obtained, to provide the Company with information regarding my character, general reputation, personal characteristics, and other pertinent information.
I hereby voluntarily authorize Company to procure an investigation, or cause an investigation to be procured, for employment purposes. I authorize, without reservation, any person or entity contacted by the organization, or anyone acting on its behalf, to furnish the above stated information. I understand that I must provide sufficient identifying information to adequately complete this investigation and acknowledge that this information will not affect any hiring or employment decisions.
Prior to signing this Authorization to Release Information and Records, I received and read a document entitled “Fair Credit Reporting Act Disclosure,” which defined the terms “consumer,” “consumer report,” “investigative consumer report” and “consumer reporting agency.”
Disclaimer regarding Credit Histories: I understand that the Company is not requesting, and will not obtain or use, information pertaining to my credit history (as that term is defined by Oregon law) at this time. I further understand that the Company will not use or obtain my credit history information absent a separate authorization from me to release that information.
Printed Name
Signature
Date
Please complete the following for proper identification purposes only.
Name
Social Security Number
Date of Birth
Current Address
Driver’s License No. and State
Other names or social security numbers you have used (if none, write “none”)
Please attach a list of addresses for the past ten years, including dates at each address.