Fair Credit Reporting Act Disclosure Statement


FAIR CREDIT REPORTING ACT DISCLOSURE STATEMENT
In accordance with the provisions of Section 604(b)(2)(A) of the Fair Credit Reporting Act, Public Law 91-508, as amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter I, Public Law 104-208), you are being informed that reports verifying your previous employment, previous drug and alcohol test results, and your driving record may be obtained on you for employment purposes. These reports are required by Sections 382.413, 391.23, and 391.25 of the Federal Motor Carrier Safety Regulations

DATE:


SOCIAL SECURITY NUMBER:

DRIVER'S LICENSE NUMBER:

DATE OF BIRTH:

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: Fair Credit Reporting Act Disclosure Statement
lock iconUnique Document ID: 2bdcf39f13ef4973e4b60b75a02fd8f3fc802d35
TimestampAudit
July 2, 2017 10:14 pm CDTFair Credit Reporting Act Disclosure Statement Uploaded by Lynn Moore Schiffman - lynn@schiffmantrucking.com IP 122.54.156.240