Do you agree to the following Disclosure and Release Authorization?
In connection with my application for employment Top Hat Chimney Sweeps, LLC. These consumer reports may include the following types of information: names and dates of previous employers, salary, work experience,
education, accidents, licensure, etc. I further understand that such reports may contain public record information such as, but not limited to: my driving record, workers’ compensation claims, judgments, bankruptcy proceedings, criminal
records, etc., from federal, state and other agencies which maintain such records. In addition, investigative consumer reports as defined by the federal Fair Credit Reporting Act, gathered from personal interviews with former employers
and other past or current associates of mine to gather information regarding my work performance, character, general reputation and personal characteristics may be obtained.
I have the right to make a request to the consumer reporting agency: USAINTEL, Inc. 8730 Wilshire Blvd, Suite 412,
Beverly Hills, California 90211; telephone (888) 409-1819 (“Agency”), upon proper identification, to request the nature and substance of all information in its files on me at the time of my request, including the sources of
information and the agency, on our behalf, will provide a complete and accurate disclosure of the nature and
scope of
the investigation covered by the investigative consumer report(s); and the recipients of any reports on me which the
agency has previously furnished within the two year period for employment requests, and one year for other purposes
preceding my request (California three years). I hereby consent to your obtaining the above information from the
agency. You may view our privacy policy at our website: www.usaintel.com. I hereby authorize procurement of
consumer report(s) and investigative consumer report(s). If hired (or contracted), this authorization shall remain on
file and shall serve as ongoing authorization for you to procure consumer reports at any time during my employment
period.