Scribd Logo
Upload

Welcome to Scribd!

  • Investigative Consumer Report On You in Connection With Your Employment Application, and If You

    Uploaded by

    Levi C
    12 views15 pages

    Original Title

    investigative consumer report on you in connection with your employment application, and if you

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    12 views15 pages

    Investigative Consumer Report On You in Connection With Your Employment Application, and If You

    Uploaded by

    Levi C

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 15
    BACKGROUND CHECK AUTHORIZATION id property, In the interest of maintaining the safety and security of our customers, employees, an¢ Pt ‘Complete Disaster series (ihe Company”) will order a “consumer report (a background report) oF ssauaigative consumer report” on you in connection with your employment SPEC and if you are hired orf you already work forthe Company, may order additional background PoP tN for ‘employment purposes. The background check company, (the "Background Cae Cont doy?), wil prepare the background report fr he Company. The Background ee k Gonpany can be reached by phone at 1-888-763-7972 _or at thelr Internet Web sie A000 Oa ee the “Background Check Company", wil prepare the background report FOF the ‘Company. “The Background Check Company can be reached by phone at or ‘The background report may contain information conceming your character, general reputation, Sant ies, mode of living, nd credit standing. The types of information that may be eejered include but are aot limited to: Social Security number verification; criminal, public, eincarional and, as appropriate, driving records checks; verification of prior employment; reference, Toning and certification checks; credit reports; drug testing results; and, if applicable, worker's compensation injuries. ‘at their Intemet Website Address Workers’ compensation information will only be requested in compliance with federal Americans with Detiice Act and/or any other applicable federal, state or local laws and only ater a conditional job offer is made. Credit history will only be requested when permitted by law and where such information ‘eeabetamtally related to the duties and responsibilities ofthe postion for which you are applying. The information may be obtained from private and public record sources, including personal interviews with your associate, frends, and neighbors. (An “investigative consume report” is a background report that includes information from such personal interviews, except in California where that term, neans any background report that is not a credit report) “The nature and scope ofthe most common form of investigative consumer report is an investigation into your education and/or employment history conducted by the Background Check Company oF “another outside organization. You may request more information about the nature and scope of an investigative consumer report, if any, by telephoning the Company at (844) 777-7237. ‘A summary of your rights under the Fair Credit Reporting Acts also being provided to you with this form. The Fair Credit Reporting Act gives you specific rights in dealing with consumer reporting agencies. You will find these rights ‘summarized in A Summary of Your Rights Under the Fair Credit Reporting. AUTHORIZATION FOR BACKGROUND CHECKS ‘After carefully reading this Background Check Disclosure and Authorization form, [ authorize the ‘Company to order my background repor, including investigative consumer reports. I understand that the Company may rely on this authorization to order additional background reports, including Page 1 investigative consumer repos, during my employment without asking me for my authorization 3 as allowed by law. Tals authorize the following agencies and entities to disclose to the Background Check Company and its agents all information about or concerning me, including but not limited to: my past or ea ‘employers; leaming institution, including colleges and universities; law enforcement and al ot federal, state and local agencies; federal, state and local courts; the militar; credit bureaus; testing facilities; motor vehicle records agencies; if applicable, worker's compensation injuries; all other private and public sector repositories of information; and any other person, organization, or agency with any information about or concerning me. Workers’ compensation information will only be requested in compliance with federal Americans with Disabilities Act and/or any other applicable federal, state of local laws and only after a conditional job offer is made. The information that can be disclosed to the Background Check Company and is agen includes, but is not limited to, information concerning my employment history earings history, education, credit history, motor vehicle history, ‘criminal history, military service, professional credentials and licenses and substance abuse testing. 1 agree the Company may rely on this authorization to order background reports including investigative consumer report, from companies other than the Background Check Company without asking me for my authorization again as allowed by law. I also agree that a copy of this form is valid like the signed original. I certify that all ofthe persona information I provided is true and correct. First Name_/eus LastName_(lerancl _____Middle_ \__ Maiden / Other Names} Years Used_M/e, If you live or work for the Company in California, Minnesota, or Oklahoma; Check this box if you ‘would lik a free copy of your backed check report: 0 / Signature of Releasor.,/— = Date: Page 2 Authorization to Obtain Motor Vehicle Record | FY AS FOLLOWS: THE UNDERSIGNED DOES HEREBY ACKNOWLEDGE AND CERTIFY A‘ employee 1. Cais that he undersigned ian employes of has applied t besome an employe ofthe tow ramed employer ina pestion which volves the epraion of 0 vehicle and the undersigned gives his or her consent to the release of their driving Teor MVR) frre by! - Complete Disaster Services ‘Name of Employer or Potential Employer 2 Thatthe undersigned authorizes his or her driving record wo be periodically obtained and reviewed forthe purpose of initial and continued employment. 3. Thatall information presented inthis form is true and correct. ‘The undersigned ‘makes this certification and affirmation under penalty of perjury and understands that knowingly making false statement or representation on this form is a eriminal Violation, Name of Employee/potemial employee: _(¢ Micl Print name as appears on driver's license License Number & State: _32 206 jsef +A DateofBink: (0 / (3 1 (944 ve he Signature of employee/potential employee: ie ean ae Employer Authorized Representative Name: ee ‘Authorized Representative Signature: Date: Re a Coss) ee ie “Restoration with you in ming” FIRE * WATER * STORM 1 Leu. Corcrnel _ nereby acknowledge and agree to the following statements: ‘Company Credit Cards & Vendor Accounts «© Company accounts and credit cards will not be used to purchase tools by employees under any Greumstances. ‘© Company credit cards may not be used for any personal purchases at any time. NOTE: Company cards and Vendor Accounts are to be used to purchase job materials and supplies only. ‘Should a tool be requited fo a specific job, management MUST be notified immediately Sales Receipt Submission © Allcredit card receipts MUST be retained and submited tothe office each week ‘0 This includes ALL receipts forthe following Company Accounts: © BRT Credit Card = LOWE'S Credit Card = Home Depot Credit Card ‘Mandatory PO Name: ‘+ Acomplete PO name or Address MUST be provided to vendor upon any purchase of material for job, | agree to return all credit cards tothe company, fat any point my employment ends with Complete Disaster Services. | understand that any misuse ofthe credit cards or other violation of this agreement, wil result in cancelation ofthe credit card and I wl be subject to disciplinary action up to and including termination ‘of employment. we Jy 29 (Jaregesemure Date July 9, 2022 mcr ame RE ME SUE POEL IS EN A ARTS LT AT SO eT OE men me Employment Eligibility Verification Department of Homeland Security U.S. Citizenship and Immigration Services START HERE: Reed sons crea ere comping win form The irons mat be evan oer PS ‘tng competion fh form, Employers oe aie fo eer i the competion o 8 frm. ANTLDISCRIMINATION NOTICE: tis galt criminal agar! work eutrnd rte Employers CANNOT spac whi document) SEENON WTCE: te Boe er ray, Toe aarti sn ene ei PY ei enti a ea TR | ‘Section 7. Employeo “ak Aiketation (Employees mnt conga ond ein Socio tof Form 1000 ee! han the first day of employment, but not bofore accepting @ job off) =— {ast Narve (Femdy Nome) First Name (Given Nome) ke wt Oar Lat Naren sed 07 eran Le wv Nf [Adress (Street Number and Name} [Ak Number [City or Town le 729_Shickler Cam em 4 ht a ee whe ret ee emma ttm | oe ee 1 Gare Form W- to your errghoper 20; See > You ea mej Tre Step i: [Omer Tara ft aan Enter ‘ M Creranol i. —_____— Porson | =a [Strickler Scwol tect. ara errant, oman ech Ee le, CA 17206 mee a ial ctesinem ar gy at tree (Dnt etna nen yr rari py man al ee nr ox eb re ot PI) ‘Complete Stops 2-4 ONLY it they apply to you, otherwise, skp to Step 5. Sex page 2 for more information on wach ep, Who Ca) ‘aim exemption tom wiivldng, when to ws the estimator at ww ra gov"V4App, ar pay Stop 2 “Cormpte ti step you (1) hold mane tan one jab a a tine, o* (2) are marred fing jonity and you pose Muttiple Jobs 80 wars. The coecterourt of witecceg depends on come eared rom af of rasa ots. or Spouse Doonly one ofthe folowing. Works (a) Use the estimator at www ie govtW4op for mast accurate witinoiding fortis stop (and Steps 3-4): OF (0) Use the Muttile Jats Wrksheet on page 3 and enter he reautn Step 4) below for roughly accurate wenbekiog: or {6} 1 thre are only two jobs toa, you may check tis box. Do the same on Farm W-4 for tho other jb. This ‘option s scour tor jobs with siniar pay, others, more tax than necessary may be wirheld ... ® C) “TP: To be accurate, suet 2022 Form W-4 oral oth obs. If you (or your spouse have slt-mnployrent Income, eekueg as an independent contractor, use he estimator. Complete Stops 5-(2) on Form W-4 for only ONE of these Jobs. Leave thoze steps bank forthe other Jb. (Your withing wit be most accurate you Completa Steps 3b) onthe For W-8 for he highest paying jab) Stop i yar total cor wal be $200,000 or tas ($400,000 or os H mari cg fly: Claim util he eurbar of qualtyieg chron under age 17 by $2,000 $ Ceecaccokes til tha narber ot ther dependents by $500... HS. ass na arouts seove wed ertur tre wishhore als Step 4 (a) Other income (nat from Jobs). if you want tax withheld for other income you (optional): ‘expec hia year that won't have withing, erter the amount of athar income ‘This may inclu intrest, drvdends, and retirement income... ‘Adjustments () Deductions you expact to claim daductons cher than the tardard deduction ant wart to reduce you whaling, wos the Deductions Worksheet on page 3 and enter the oat hew. ie of (6) Extra witnholding Erter ary adcional tax you want wield each pay period... [aje)|S ge Py a ee ee peapti}aa Employers | Eneloys tare wr wares Fiat date of Employer ertiicaion erploymert | rumour) ‘For reacy het end Paperwork Redaction KA Noice, soe page 3. oan ee Fern WA zh Foren age 9 ‘Stop 2{b)—Multiple Jobs Worksheet (Keep for your records.) {yu choose the option in Stop 20) on For W-4, complete tis warkahost (wich calculates th total era tax for al fobs) on only ONE Farm W-4. Wtnlding wi be most accurate you camglete the werksheet and ene the reul onthe Fox Wor he highest paying fo. "Note: mare than one jb has annual wages of more than $120,000 or there are more than three js, son Pub. 505 fr coral tables: oF you can use the onne withhosing extmator at wwe gow"W4Apo, 1 Two Jobst you have two jobs or you'r marred fing jority and you and your spouse wach have one pb. find the amount rom the appropriate tabla on page 4, Uing the “Higher Paying Job" row and the Lower Paying Job" column, find the val at tho Intersection ofthe two housahold salaries and enter that vale online 1. Then, skip toe 3 : cs ci 2 Theo Jobs. you andor your spouse have thrwo jobs a the same time, complete lines 2a, 2b, and 2c bolow. Otherwise, skip to line 3 ‘2 Find the amount trom the appropriate table on pago 4 using the annual wages from the highest paying jo inthe “Highar Paying Job” row and tho annual wages for your next ghost paying ob Inthe “Lower Paying Job" column. Find the valu a tho Intersection of ho two household salaries fang enterthatvaluo Onn 280. ee Mg he 1b Ad the annul wages ofthe two highest paying Jobs from Ino a together and use te total ss the ‘wages in th “higher Paying Job" row and uso the annual wages for you thi Jobin tho “Lower Paying Job" column to find the amount from the appropriat table on page 4 and enter tis amount contine 25 Se eh gsh as me © Ad tho amounts rom ines 2aand 2b end enter theresutontine 2c... 2. ss BS ‘2 Enter te numberof pay periods per year fr the highest paying Job. For example, if that job pays eel, enter 52; it pays every cther week, enor 26; Hit pays monty, ontr 12... = = 44 Divide tho annual amount on ine 1 oF tine 2¢ by the number of pay perods on tne 9. Enter this, ‘amount here and in Step 4) of Form W-4 forte highest paying Job (along with any other aditonal amount youwant with see es es Rae aN Ans ‘Step 4(b)—Deductions Worksheet (Keep for your records, 11 Entor an estimate of your 222 terized deductions (rom Schedule A Form 1040). Such deductions ‘may include quaifying home morgage Interest, chartable contrbutions, stato and local taxes (up 0 $10,000), anc meciea expenses in excoes of7.5% of yourincome se ws a + $25,900 youre mari fing jit or valving widow 2 eoac | Entnineedatenmas | + $12,850 youre single or mated fing soparatly 8 tfng 1 is greator than ino 2, subtract Ino 2 from tne 1 and enter the result hee. If ine 2 is greater thane fete ee ae 4 Enter an estimate of your student loan interest, deductible IRA contibutlons, and certain other _agustments (om Par I of Schedule 1 (Form 1040). See Pub, S05 for moro information 4 feel li 5 Add ines 9 and 4, Entor the result here and in Stop fb) of Form W-4 Yaaro wae rodeo eratn rege na om Bat a siete Paprwon educton hts Oty Sapoesasg OD Serene Soames ag oo aces ra ‘sated ong es a cost nay beet nocd nace ‘Syma vou aw. Gowler aed et owt a “Ta gage tw ae perso reais to compet ei wit ry ipordg an tia reuse. Fe ected svgen, sess youve sugges tr maerg thom sng, we wold bs hay ‘omyou Sate Femara wearer eal Fem W000) General Instructions ‘Section references are to the Internal Revenue Code, Future Developments For the latest information about developments related to Form W4, such aa legislaion enacted after ft was pulled, {90 to wins. goviForiv. Purpose of Form ‘Complete Form W-4 so that your employer can withhold the crusader aes car stay on te meneame tonal tonsa dander mente Poca, ‘ueiweler rer fren Sebago gece SRE ete Enron on ty says rr fereaton eer ese, soulen pote eamcers ate a ere dcret terran mee 2022. You had no federal income tax lability in 2021 # (1) Pe centages (A Beciaecnermcatsc ah Seta sis ownemere mente oe fetes tet tet et a Sak ute eo ea iifad oa ava cs iti alana ce a Serta ay a ice ry hse eaten Sheetal na crear, esESeconts Syms eats ieutio ta tp Forney. trupte win oman oda Seateyt cunts emcee, mabey aegectrane nbeerna thn cas ssa meee ee SLE a ees at ae Bye rite ren tenet Siti eat man aa mee draiseaierer rage Ie caer oe ena sirawec Wer ong tint: Coe ge sir menomtaee 1 Spt wot oot esr, 2 ide ep gn or it i Sesto Shastry eat 4, Prefer the most accurate withholding for muttiple job zie Stems Srey yin trae ‘self-employment taxes on any self-employment income you Sateen ter eagereten Sere miyierees See emew nets wrest Setar Ch won teeny reat ene Peete An, aay Se i ‘Specific Instructions Stop 1(c). Check your anticipated fing status. This wil

    You might also like