APPLICATION NOTIFICATION AND RELEASE
In connection with my application for employment (including contract for services) with you, I understand that a consumer report which may contain public record information is being requested. This report may include the following types of information: name and dates of previous employers, information concerning my driving record, workers compositions claims, credit bankruptcy proceeding, criminal records, etc, from federal, state and other agencies or any other party concerning previous driving records.
I AUTHORIZE WITHOUT RESERVATIONS; ANY AGENCY CONTACTED BY US TO FURNISH THE ABOVE MENTIONED INFORMATION