Authorization for Background Investigation
Consumer Report Authorization Form
Contents
Acknowledgments
By signing below, I acknowledge that:
1. I have received and read the "Disclosure Regarding Background Investigation"
2. I understand that a consumer report may be obtained about me
3. I authorize the release of this information
4. I understand my rights under the FCRA
5. A copy of this authorization is as valid as the original
Certification
I certify that all information provided in connection with this background check is true and complete to the best of my knowledge.
I understand that falsification or omission of information may result in:
- Denial of engagement
- Termination of existing engagement
Release of Liability
I release Automate America, Inc., its agents, and the consumer reporting agency from any liability arising from:
- The investigation itself
- The disclosure of the results to authorized parties
- Any decision made based on the consumer report
This release is subject to applicable federal and state laws.
Duration of Authorization
This authorization:
- Is valid for the duration of my engagement with Automate America, Inc.
- Allows for periodic re-investigations as required by client contracts
- May be revoked by me in writing at any time, though revocation does not affect actions already taken
If I am assigned to a new client that requires a background check, I understand a new investigation may be conducted under this authorization.
Electronic Signature
By clicking "I Authorize" or providing my electronic signature below, I:
- Authorize the background investigation
- Acknowledge receipt of the FCRA disclosure
- Certify the information I provided is accurate
- Understand this authorization is valid for the duration of my engagement
This electronic authorization has the same legal effect as a handwritten signature pursuant to the Electronic Signatures in Global and National Commerce Act (ESIGN Act), 15 U.S.C. ยง 7001 et seq.
Acknowledgment
IMPORTANT: Before authorizing, ensure you have:
1. Read the FCRA Disclosure document
2. Understood your rights under the Fair Credit Reporting Act
3. Provided accurate personal information
Questions? Contact legal@automateamerica.com or call 586-770-8083.
Automate America, Inc.
PO Box 1638, Greer, SC 29652
