Sample documents should NOT be construed as legal advice, guidance or counsel. Employers should consult their own attorney about their compliance responsibilities under the FCRA and applicable state law. Accurate Background LLC., expressly disclaims any warranties or responsibility or damages associated with or arising out of information provided. Employers seeking credit reports must provide additional notices pursuant to state law.

ACKNOWLEDGMENT AND AUTHORIZATION REGARDING BACKGROUND CHECK

I acknowledge receipt of the separate documents entitled DISCLOSURE REGARDING BACKGROUND CHECK, DISCLOSURE FOR INVESTIGATIVE CONSUMER REPORT, if applicable, A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and OTHER STATE LAW NOTICES and certify that I have read and understand each of those documents. I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” by [End User] (the “Company”) at any time after receipt of this authorization and throughout my employment, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by Accurate Background, 200 Spectrum Center Dr. Suite 1100, Irvine, CA 92618, (800) 216-8024, www.accurate.com and/or [End User]. This information may include, but not be limited to, information regarding my criminal history, social security verification, motor vehicle records (“driving records”), verification of my education or employment history, or other background information. I agree that a facsimile (“fax”), electronic or photographic copy of this Authorization shall be as valid as the original.

Signature: ________________________________________________________ Date: _____________

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