Common use of STATE LAW NOTICES Clause in Contracts

STATE LAW NOTICES. If you live or work for the Company in the states listed below, please note the following: Minnesota applicants only: You have the right, upon written request to LSS, to receive a complete and accurate disclosure of the nature and scope of any consumer report. LSS must make this disclosure within five days of your request for disclosure or of the Company’s request for the report, whichever is later. Minnesota / Oklahoma applicants: You have the right to receive a copy of your consumer/investigative consumer report by checking “Yes” below. Please check the appropriate box if you would like to receive a free copy of your consumer report. YES NO New Jersey applicants: If you submit a request to us in writing, you have the right to know whether the Company ordered an investigative consumer report from LSS. You may inspect and order a free copy of the report by contacting LSS. New York applicants: If you submit a request to us in writing, you have the right to know whether the Company ordered an investigative consumer report from LSS, and you will be provided with the name and address of LS Screening. You may inspect and order a free copy of the report by contacting LSS. By signing below, you certify that you have received a copy of New York Correction Law 23-A. Washington State applicants: If the Company requests an investigative consumer report, you have the right, upon written request made to the Company within a reasonable period of time after your receipt of this disclosure, to receive from the Company a complete and accurate disclosure of the nature and scope of the investigative consumer report requested by the Company. You also have the right to ask LSS for a written summary of your rights under the Washington Fair Credit Reporting Act. ACKNOWLEDGMENT AND AUTHORIZATION FOR BACKGROUND REPORTS By providing the requested information and signing below, I acknowledge receipt of the Background Screening Disclosure and Authorization Notice, A Summary of Your Rights under the Fair Credit Reporting Act (available at xxxx://xxxxx.xxxxxxxxxxxxxxx.xxx/f/201410_cfpb_summary_your-rights-under-fcra.pdf) and any other document referenced in this Background Screening Disclosure and Authorization Notice and certify that I have read and understand all of those documents provided to me by the Company. By my signature below I hereby authorize the Company to obtain consumer reports and/or investigative consumer reports for employment purposes at any time after receipt of this authorization and, if I am hired, throughout my employment. 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 LS Screening, PO Box 3051, Forney TX 75126, (000) 000-0000 Voice/(000) 000-0000 Fax. I agree that a facsimile (fax), electronic or photographic copy of this Authorization shall be as valid as the original. I understand that signing my name below, constitutes my consent and that by doing so: I am acknowledging Company has disclosed that they may request a consumer report or investigative consumer report; that I am authorizing LS Screening to conduct the background check(s) described above; and I certify that facts and information in this form and any attachments I have provided are true, accurate, and complete to the best of my knowledge. PLEASE PROVIDE ALL INFORMATION AND PRINT CLEARLY APPLICANT’S LEGAL NAME: Last Name First M.I. SOCIAL SECURITY #: DATE OF BIRTH: Month/Day/Year CURRENT HOME ADDRESS: Street City/State Zip DRIVER’S LICENSE #: STATE OF ISSUANCE: EMAIL ADDRESS: APPLICANT SIGNATURE : DATE: xxx.xxxxxxxx.xxx Fax to (000) 000-0000

STATE LAW NOTICES. If you live or work for the Company in the states listed below, please note the following: Minnesota applicants only: You have the right, upon written request to LSS, to receive a complete and accurate disclosure of the nature and scope of any consumer report. LSS must make this disclosure within five days of your request for disclosure or of the Company’s request for the report, whichever is later. Minnesota / Oklahoma applicants: You have the right to receive a copy of your consumer/investigative consumer report by checking “Yes” below. Please check the appropriate box if you would like to receive a free copy of your consumer report. YES NO New Jersey applicants: If you submit a request to us in writing, you have the right to know whether the Company ordered an investigative consumer report from LSS. You may inspect and order a free copy of the report by contacting LSS. New York applicants: If you submit a request to us in writing, you have the right to know whether the Company ordered an investigative consumer report from LSS, and you will be provided with the name and address of LS Screening. You may inspect and order a free copy of the report by contacting LSS. By signing below, you certify that you have received a copy of New York Correction Law 23-A. Washington State applicants: If the Company requests an investigative consumer report, you have the right, upon written request made to the Company within a reasonable period of time after your receipt of this disclosure, to receive from the Company a complete and accurate disclosure of the nature and scope of the investigative consumer report requested by the Company. You also have the right to ask LSS for a written summary of your rights under the Washington Fair Credit Reporting Act. ACKNOWLEDGMENT AND AUTHORIZATION FOR BACKGROUND REPORTS By providing the requested information and signing below, I acknowledge receipt of the Background Screening Disclosure and Authorization Notice, A Summary of Your Rights under the Fair Credit Reporting Act (available at xxxx://xxxxx.xxxxxxxxxxxxxxx.xxx/f/201410_cfpb_summary_your-rights-under-fcra.pdf) and any other document referenced in this Background Screening Disclosure and Authorization Notice and certify that I have read and understand all of those documents provided to me by the Company. By my signature below I hereby authorize the Company to obtain consumer reports and/or investigative consumer reports for employment purposes at any time after receipt of this authorization and, if I am hired, throughout my employment. 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 LS Screening, PO Box 3051, Forney TX 75126, (000) 000-0000 Voice/(000) 000-0000 Fax. I agree that a facsimile (fax), electronic or photographic copy of this Authorization shall be as valid as the original. I understand that signing my name below, constitutes my consent and that by doing so: I am acknowledging Company has disclosed that they may request a consumer report or investigative consumer report; that I am authorizing LS Screening to conduct the background check(s) described above; and I certify that facts and information in this form and any attachments I have provided are true, accurate, and complete to the best of my knowledge. PLEASE PROVIDE ALL INFORMATION AND PRINT CLEARLY APPLICANT’S LEGAL NAME: Last Name First M.I. SOCIAL SECURITY #: DATE OF BIRTH: Month/Day/Year CURRENT HOME ADDRESS: Street City/State Zip DRIVER’S LICENSE #: STATE OF ISSUANCE: EMAIL ADDRESS: APPLICANT SIGNATURE : DATE: xxx.xxxxxxxx.xxx Fax to (000) 000-0000.