BACKGROUND SCREENING AUTHORIZATION

I acknowledge receipt of the separate documents entitled Background Screening Disclosure, Background
Screening Disclosure For Investigative Consumer Reports, and A Summary of Your Rights Under the Fair Credit
Reporting Act (via myKelly.com, or a printed copy of the Summary may be obtained through my
representative), and certify that I have read and understand these documents1. I hereby authorize the
obtaining of “consumer reports” and/or “investigative consumer reports” by Kelly Services, Inc. and/or its
subsidiaries (“Kelly” or “Kelly Services”) at any time after receipt of this authorization and throughout my
employment, if applicable. To this end, I hereby authorize 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 Kelly Services or its
representative. I further authorize that information obtained in consumer reports and/or investigative
consumer reports may be shared with Kelly Services customers. 2
By checking this box, I agree that Kelly Services may contact my current employer.
Kelly Representative Instructions: If the applicant does not check the box above, do not select or
include the current employer when completing the request for a background screen.

New York applicants/employees only: Upon request, I understand that I will be informed whether or not a
consumer report was requested by Kelly, and if such report was requested, informed of the name and address
of the consumer reporting agency that furnished the report. I understand that I have the right to inspect and
receive a copy of any investigative consumer report requested by Kelly by contacting the consumer reporting
agency identified herein. I also acknowledge receipt of Article 23-A of the New York Correction Law.
Minnesota applicants/employees only: I understand I have the right to submit a written request to the
consumer reporting agency for a complete and accurate disclosure of the nature and scope of any consumer
report Kelly ordered about me. The consumer reporting agency must provide me with this disclosure within five
business days after its receipt of your request or the report was requested by Kelly, whichever date is later.
Washington state applicants/employees only: I understand that I have the right to request from the
consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit
Reporting Act.

Applicants/employees in California, Minnesota, and Oklahoma:

By checking this box, I request a free copy of a consumer report if one is obtained by Kelly.

I agree that a facsimile (“fax”), electronic, or photographic copy of this Authorization shall be as valid as the original.

I have read this Background Screening Authorization, I understand it, and I agree to its terms.

Cristian Castro 8403

Full Legal Name (Printed) Last 4 digits of SSN

Signature Date

1
Applicants/employees in California: By signing this form, you acknowledge receipt of a separate document titled California
Background Screening Notice.
2
Not applicable for internal Kelly applicants, except where required for on-site positions.

© 2021 Kelly Services, Inc. An Equal Opportunity Employer e336 Revised March 2021