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Background Check Form

St. Peter Public Schools is obtaining a background check on a volunteer from Absolute Background Concepts. The volunteer will be subject to a consumer report and/or investigative consumer report that may include criminal history, driving history, employment and education references, social media checks, and other publicly available information. The volunteer authorizes Absolute Background Concepts to provide these reports to St. Peter Public Schools and third parties the volunteer may work with. The volunteer has rights to request the nature and scope of any reports.

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92 views2 pages

Background Check Form

St. Peter Public Schools is obtaining a background check on a volunteer from Absolute Background Concepts. The volunteer will be subject to a consumer report and/or investigative consumer report that may include criminal history, driving history, employment and education references, social media checks, and other publicly available information. The volunteer authorizes Absolute Background Concepts to provide these reports to St. Peter Public Schools and third parties the volunteer may work with. The volunteer has rights to request the nature and scope of any reports.

Uploaded by

MichaelJJohnson
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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St.

Peter Public Schools


Company/Organization/School Name:_____________________________________

(Volunteer)

DISCLOSURE REGARDING BACKGROUND INVESTIGATION


[IMPORTANT -- PLEASE READ CAREFULLY BEFORE SIGNING]

Company/Organization/School may obtain information about you from a consumer reporting agency for agreed upon purposes from the following
consumer reporting agency: ABSOLUTE BACKGROUND CONCEPTS, 35 E. Minnesota St., Le Center, MN 56057, 877-572-8962 or 507-357-6320,
or from another outside organization. ABSOLUTE BACKGROUND CONCEPTS privacy policy can be found at www.abcnationalbackground.com.
Thus, you may be the subject of a consumer report and/or an investigative consumer report which may include information about your character,
general reputation, personal characteristics, and/or mode of living. These reports may be obtained at any time after receipt of your authorization and,
if you are chosen to volunteer, throughout your association with said company/organization/school. Company/Organization/School also reserves the
right to share background investigation results with third-party companies for whom you will be placed to work with as a representative of
company/organization/school. These reports may include, but are not limited to, checks regarding your criminal history, social security trace, driving
history, employment and education references, professional licenses and credentials. Credit history will be requested only in accordance with
applicable law. These reports may contain information regarding your use of social media, and other publicly accessible information. Social media
includes, but is not limited to, social networking websites (i.e., Facebook and others), professional networking websites (i.e. LinkedIn and others),
blogs, and other online media.

ACKNOWLEDGMENT AND AUTHORIZATION


[IMPORTANT -- PLEASE READ CAREFULLY BEFORE SIGNING]
I acknowledge receipt of the DISCLOSURE REGARDING BACKGROUND INVESTIGATION and A SUMMARY OF YOUR RIGHTS
UNDER THE FAIR CREDIT REPORTING ACT and certify that I have read and understand both documents. I hereby authorize
procurement of consumer reports and/or investigative consumer reports at any time after receipt of this authorization and throughout
my association with said company/organization/school. 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 ABSOLUTE BACKGROUND CONCEPTS, 35 E. Minnesota St.,
Le Center, MN 56057, 877-572-8962 or 507-357-6320, www.abcnationalbackground.com, another outside organization acting on behalf of
Company/Organization/School, and/or Company itself. I authorize these agencies to provide you with consumer and investigative
consumer reports. I agree that a facsimile (fax), electronic or photographic copy of this Acknowledgment and Authorization shall be
as valid as the original.
The scope of this disclosure and authorization is all-encompassing, however, allowing the Company/Organization/School to obtain from any outside
organization all manner of consumer reports and investigative consumer reports now and throughout the course of your association with said
company/organization/school to the extent permitted by law. As a result, you should carefully consider whether to exercise your right to request
disclosure of the nature and scope of any investigative consumer report.
My authorization is conditional upon the following representation of my rights: You have the right, upon written request made within a
reasonable time after receipt of this notice, to ask the Company/Organization/School to disclose the nature and scope of any consumer report. You
may also request a copy of that report from the Company. You also may request a copy of that report from Absolute Background Concepts. If anyone
other than Absolute Background Concepts furnishes an investigative consumer report, the Company/Organization/School will provide relevant contact
information within five business days of your request. An "investigative consumer report" is a background report that includes information from
personal interviews (except in California, where that term includes background reports with or without personal interviews). Please be advised that the
nature and scope of the most common form of investigative consumer report obtained with regard to applicants for volunteering is an investigation into
your education and/or employment history conducted by Absolute Background Concepts via interviews with past employers, neighbors, friends or
associates.

I understand that by signing and dating below:


I am authorizing Absolute Background Concepts to conduct the consumer report described above;
I authorize the Company/Organization/School to share reports with third party companies for whom I may be placed to volunteer;
I have read and understand the Disclosure Regarding Background Investigation above;
I have read and understand the Acknowledgment and Authorization above.

Signature of applicant

Social Security Number

Print Name
Issued

Date of Birth*

Todays Date
Drivers License Number & State

Current Address
* This information will be used for background screening purposes only and no other purpose.
Rev. 1/2015

PLEASE LIST ANY NAMES USED IN THE PAST 7 YEARS:


______________________________________________________________________________________________________________

STATE SPECIFIC RIGHTS OF APPLICANTS OR EMPLOYEES


REGARDING BACKGROUND INVESTIGATION
Specific to CA, MN, NY, OK applicants or employees but available to all applicants or employees:
You have the right to promptly receive and inspect a copy of any consumer report, consumer investigative report, or consumer
credit report requested on you by the Company/Organization/School, at no charge, by contacting the
Company/Organization/School, or, contact the consumer reporting agency, ABSOLUTE BACKGROUND CONCEPTS toll free at 877-5728962, or email [email protected]
Check here to receive a copy of your consumer report directly from the Company/Organization/School.

California applicants or employees:


By signing below, you also acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION PURSUANT TO
CALIFORNIA LAW. If you did not receive a copy of the Notice, please contact ABSOLUTE BACKGROUND CONCEPTS toll free at 877572-8962 or email [email protected] to request a copy.

New York applicants or employees:


By signing below, you also acknowledge receipt of Article 23-A of the New York Correction Law. If you did not receive Article 23-A,
please contact ABSOLUTE BACKGROUND CONCEPTS toll free at 877-572-8962 or email [email protected] to request a copy, or visit
https://www.labor.ny.gov/formsdocs/wp/correction-law-article-23a.pdf

Washington State applicants or employees:


You have the right to request from the consumer reporting agency a written summary of your rights and remedies under
Washington state laws. Contact ABSOLUTE BACKGROUND CONCEPTS toll free at 877-572-8962 or email [email protected] to request
a copy. You may also contact the Washington Attorney General, Consumer Protection Division, 800 5th Ave. Suite 2000, Seattle,
WA 98104-3188.

I have read and understand the STATE SPECIFIC RIGHTS OF APPLICANTS OR EMPLOYEES above.

Signature of applicant

Rev. 1/2015

Print Name

Todays Date

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