FAIR CREDIT REPORTING ACT DISCLOSURE Sample Clauses

FAIR CREDIT REPORTING ACT DISCLOSURE. I hereby authorize The Xxxxxx Health System and/or its designee to obtain and investigate the following: criminal and/or motor vehicle records, personal references and characteristics, background, general reputation and character, mode of living, and/or any other similar information if I do not have a professional license for which criminal background checks are mandated for license renewal. I acknowledge I have been notified by The Xxxxxx Health System that it may procure a consumer report. In the event information from the report is utilized in whole or in part in making an adverse employment decision, I understand I will be notified of such action and provided with a copy of the consumer report and a description in writing of my rights under the Fair Credit Reporting Act. I understand that the above investigation may be performed for purposes of the Health Care Professional Responsibility and Reporting Act, N.J.S.A. 45:1-33 et seq. I acknowledge this authorization remains valid for the duration of my employment with The Xxxxxx Health System. I understand The Xxxxxx Health System may consider such information in making decisions related to my employment and/or continued employment including but not limited to hiring, evaluation, compensation, promotion, retention, reassignment, termination and any other term or condition of employment. By signing below, I hereby authorize all entities having information about me, including present and former employers, criminal justice agencies, department of motor vehicles, schools, credit reporting agencies and/or other similar entities, to release such information to The Xxxxxx Health System and/or its designee. I hereby release The Xxxxxx Health System, its officers, agents, representatives and/or employees, and any entity that provides such information in response to a request by The Xxxxxx Health System, from any and all liability resulting from and/or related to the release of such information. Dated:
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FAIR CREDIT REPORTING ACT DISCLOSURE. As affiliates, Cyprus Federal Credit Union and Cyprus Financial Services and Insurance are permitted by law to share any information about their transactions or experiences with you. Information taken from credit reports may also be exchanged but will not be shared if you notify us in writing. If you elect to opt out of this information exchange, please indicate your intentions on the attached form and mail it as instructed.
Sample 1
FAIR CREDIT REPORTING ACT DISCLOSURE. The Fair Credit Reporting Act governs the sharing of information that may impact upon you for purposes involving credit, collections, employment, insurance, and other purposes set forth in Section 604 of the Act. We learn information about you from our experience with you and from information provided by others, such as through credit reports. The Fair Credit Reporting Act permits us to share with our affiliates and credit reporting agencies information we learn from our experience with you. We may also share information provided by others but will not share this information if you direct us otherwise. You may direct us not to share the information provided by others by exercising your opt-out election in the same manner as set forth above. In the opt-out election, you will have the option of including or excluding the Credit Union from your opt-out election.
Sample 1
FAIR CREDIT REPORTING ACT DISCLOSURE. In compliance with the Fair Credit Reporting Act (FCRA) you are hereby notified that Forethought Life Insurance Company may obtain a consumer report, or investigative consumer report, including information as to your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, mode of living, criminal records, and employment history. Such inquiry will be made upon our receipt of your completed Agreement. By signing this Agreement, you authorize us to make these inquiries. You have the right to obtain a complete and accurate disclosure of the nature and scope of the investigation requested and a summary of your rights under the FCRA. Upon written request to us within a reasonable time after our receipt of this document, such additional disclosure shall be made to you in writing. Please forward your request to: Forethought Life Insurance Company Attention: Agent Contracting and Licensing X.X. Xxx 000 Xxxxxxxxxx, XX 00000 Or Fax To: 000-000-0000 For additional information concerning the FCRA, you can find the complete text of the FCRA, 15 U.S.C. 1681 et seq, at the Federal Trade Commission’s web site (http:xxx.xxx.xxx.) I hereby authorize Forethought Life Insurance Company to initiate automatic credit entries, and the financial institution named below to credit the same to such account. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. This authority is to remain in full force and effect until Forethought Life Insurance Company has received written notification from me of its termination, allowing Forethought Life Insurance Company enough time to act on it. Account Name (print): Account Type: 🞎 Checking Account �� Savings Account 6 AUTHORIZATION FOR AUTOMATIC DIRECT DEPOSIT (ACH CREDITS) PLEASE SUBMIT A COPY OF YOUR VOIDED CHECK WITH CONTRACTING PAPERWORK AND COMPLETE THE FINANCIAL INSTITUTION (BANK) INFORMATION BELOW: Bank Name: Bank Telephone: ( ) Bank Address: City, State, Zip: Account Number: Bank Transit/ Routing Number: ACKNOWLEDGMENTS AND SIGNATURE Under penalties of perjury, I certify that:
Sample 1
FAIR CREDIT REPORTING ACT DISCLOSURE. In compliance with the Fair Credit Reporting Act (FCRA) you are hereby notified that Forethought Life Insurance Company may obtain a consumer report, or investigative consumer report, including information as to your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, mode of living, criminal records, and employment history. Such inquiry will be made upon our receipt of your completed Agreement. By signing this Agreement, you authorize us to make these inquiries. You have the right to obtain a complete and accurate disclosure of the nature and scope of the investigation requested and a summary of your rights under the FCRA. Upon written request to us within a reasonable time after our receipt of this document, such additional disclosure shall be made to you in writing. Please forward your request to: Forethought Life Insurance Company Agent Contracting and Licensing X.X. Xxx 000 Xxxxxxxxxx, XX 00000 Or Fax To: 000-000-0000 For additional information concerning the FCRA, you can find the complete text of the FCRA, 15 U.S.C. 1681 et seq, at the Federal Trade Commission’s web site (http:xxx.xxx.xxx.)
Sample 1
FAIR CREDIT REPORTING ACT DISCLOSURE. I hereby authorize Forethought Life Insurance Company to initiate automatic credit entries, and the financial institution named below to credit the same to such account. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. This authority is to remain in full force and effect until Forethought Life Insurance Company has received written notification from me of its termination, allowing Forethought Life Insurance Company enough time to act on it. Account Name (print): Account Type: □ Checking Account □ Savings Account 6 AUTHORIZATION FOR AUTOMATIC DIRECT DEPOSIT (ACH CREDITS) PLEASE SUBMIT A COPY OF YOUR VOIDED CHECK WITH CONTRACTING PAPERWORK AND COMPLETE THE FINANCIAL INSTITUTION (BANK) INFORMATION BELOW: Bank Name: Bank Telephone: ( ) Bank Address: City, State, Zip: Account Number: Bank Transit/ Routing Number: ACKNOWLEDGMENTS AND SIGNATURE Under penalties of perjury, I certify that:
Sample 1

Related to FAIR CREDIT REPORTING ACT DISCLOSURE

  • CREDIT REPORTING For each Mortgage Loan, the Company shall accurately and fully furnish, in accordance with the Fair Credit Reporting Act and its implementing regulations, accurate and complete information on its borrower credit files to each of the following credit repositories: Equifax Credit Information Services, Inc., TransUnion, LLC and Experian Information Solution, Inc. on a monthly basis.

  • Credit Reports Borrower authorizes Lender to obtain a credit report on Borrower at any time.

  • Audit Reports promptly upon receipt thereof, one copy of each other financial report and internal control letter submitted to the Company by independent accountants in connection with any annual, interim or special audit made by them of the books of the Company.

  • Data Protection and Privacy: Protected Health Information Party shall maintain the privacy and security of all individually identifiable health information acquired by or provided to it as a part of the performance of this Agreement. Party shall follow federal and state law relating to privacy and security of individually identifiable health information as applicable, including the Health Insurance Portability and Accountability Act (HIPAA) and its federal regulations.

  • FAIR PRACTICES 1. As sole bargaining agent the Association shall continue its policy of accepting into membership all eligible persons in the unit without regard to age, race, color, creed and religious creed, national origin, sex, marital status, sexual orientation, veteran’s status, handicap, genetic information, ancestry, or membership or non-membership in any political or ideological organization. The Association shall represent equally all members of the bargaining unit without regard to membership or participation in the activities of any employee organization.

  • Privacy Act If performance involves design, development or operation of a system of records on individuals, this Agreement incorporates by reference FAR 52.224-1 Privacy Act Notification (Apr 1984) and FAR 52.224-2 Privacy Act (Apr 1984).

  • Audit Report 38 10.1.2 Quarterly Reports.............................................................................38 10.1.3 Monthly Reports...............................................................................39 10.1.4

  • Amendment of Protected Health Information 8.1 To the extent Covered Entity determines that any Protected Health Information is maintained by Business Associate or its agents or Subcontractors in a Designated Record Set, Business Associate shall, within ten (10) business days after receipt of a written request from Covered Entity, make any amendments to such Protected Health Information that are requested by Covered Entity, in order for Covered Entity to meet the requirements of 45 C.F.R. § 164.526.

  • Notice of Privacy Practices Business Associate shall abide by the limitations of Covered Entity’s Notice of which it has knowledge. Any use or disclosure permitted by this Agreement may be amended by changes to Covered Entity’s Notice; provided, however, that the amended Notice shall not affect permitted uses and disclosures on which Business Associate relied prior to receiving notice of such amended Notice.

  • Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an XXX, Xxxxxx MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information.

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