The FCRA requires that, before you obtain a consumer report for employment purposes, you (1) give the applicant a clear, stand-alone written disclosure and (2) obtain their written authorization. Print each form below, or adapt the text into your own document.
1. Disclosure Regarding Background Investigation
(This disclosure must be provided in a document that consists solely of the disclosure.)
[EMPLOYER NAME] ("the Company") may obtain a consumer report and/or investigative consumer report about you for employment purposes — that is, for decisions related to your employment, including hiring, retention, promotion, or reassignment. This report may include information about your identity, criminal history, prior employment or education, and, where permitted and relevant, other background information.
The report will be prepared by a consumer reporting agency: Draco Investigative Services, dracosvc.com, damien@dracosvc.com. You have rights under the Fair Credit Reporting Act; a "Summary of Your Rights Under the FCRA" is available and will be provided to you.
2. Authorization
I have read and understand the Disclosure Regarding Background Investigation above. I authorize [EMPLOYER NAME] and its designated consumer reporting agency, Draco Investigative Services, to obtain a consumer report and/or investigative consumer report about me for employment purposes, now and (to the extent permitted by law) during my employment.
I understand I may be asked to provide identifying information (which may include my full name, date of birth, and Social Security number) to help produce an accurate report.
Applicant signature: ______________________________________
Printed name: ____________________________ Date: ______________
Before and after adverse action
If you decide to take adverse action (for example, not to hire) based in whole or part on the report:
- Pre-adverse action: give the applicant a copy of the report and a copy of "A Summary of Your Rights Under the FCRA," and allow reasonable time to respond before you decide.
- Adverse action: after you decide, provide an adverse-action notice stating that the decision was based in part on the report; our name, address, and phone number; that we did not make the decision and cannot explain the reasons; and the applicant's right to a free copy of the report and to dispute its accuracy with us.
See the full Notice to Users and the Summary of Rights. Note that state and local "fair-chance" laws may add steps (such as an individualized assessment).
Provided for general information; not legal advice. Confirm current federal, state, and local requirements with qualified counsel before using these forms.