In connection with my application for employment (including contract for services) with you, I understand that consumer reports which may contain public record information may be requested from SIFT, Inc., Conyers, Georgia. These reports may include the following types of information: names and dates of previous employers, reason for termination of employment, work experience, accidents, etc. I further understand that such reports may contain public record information concerning my education, driving record, credit, workers’ compensation claims, bankruptcy proceedings, criminal records, etc. from federal, state and other agencies which maintain such records.

I AUTHORIZE, WITHOUT RESERVATION, ANY PARTY OR AGENCY CONTACTED BY SIFT, Inc. TO FURNISH THE ABOVE-MENTIONED INFORMATION.

I have the right to make a request to SIFT, Inc., 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 recipients of any reports on me which SIFT, Inc. has previously furnished within the two year period preceding my request. I hereby consent to your obtaining the above information from SIFT, Inc.

I hereby authorize procurement of 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 (or contract) period.

Please fill in the form with the appropriate information and then submit for processing.