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Sensitive Sitters:

310-203-1367
323-294-8467

646-537-1722 (NY)

...

Pre-Employment Screening Application

  • CLIENT: L.D. Sensitive Sitters
  • ADDRESS: 4831 6th Avenue
                      Los Angeles, CA 90043
  • E-MAIL: storkstops@aol.com
  • CONTACT: Vonda Dennis
  • PHONE: (323) 294-8467
  • FAX: (323) 298-3072
Data-Fax Investigations

PHONE: 661-259-5523   FAX: 661-259-5528   datafax@sbcglobal.net

PERSONAL INFORMATION
 
Date: Social Security #:
First Name: Drivers License #:
Middle Name: DL State:
Last Name: Date of Birth:
Married, Maiden, etc. (if applicable)   
Current Address:    
City: State:    Zip:   
Previous Address:    
City: State:    Zip:   
       
Page 2 or Resume/Application attached?     Yes No
Standard Profile:   $50.00  
Other:   
 
BACKGROUND INFORMATION RELEASE AUTHORIZATION

In accordance with the Privacy Act of 1974, the Fair Credit Reporting Act of 1996 and California Civil Code Section 1786.26, we must inform you that as a condition for employment consideration with our firm, it is standard procedure that all applicants participate in the pre-employment screening program.

For that purpose, we have retained the services of DATAFAX INVESTIGATIONS, a Los Angeles based, California licensed firm, specializing in pre-employment and pre-placement background investigations.

This background is designed to establish information regarding your past work history or performance, civil and criminal history, driving history, and if applicable, education and consumer credit history. Further, this investigation may be limited to the confirmation of information you supplied on the application / resume, or may involve further investigation into any pertinent area.

Participation in this program does not constitute a promise or guarantee of employment, either expressed or implied, but the mere gathering of available information to assist in the establishment of employment suitability as determined by the contract employer.

If any information should develop that results in your exclusion from further employment consideration, you may request, in writing, the nature of that information, as well as a copy of your consumer credit profile, at no cost to you.
ACKNOWLEDGEMENT AND UNDERSTANDING

Accordingly, I have read and fully understand the nature and purpose of this investigation, and the conditions thereof, and authorize its full and complete undertaking, including a consumer credit profile.

Further, I release and forever hold harmless, any and all persons or agencies, public or private, that supply information relative to this investigation, including, but not limited to, the following:

Consumer credit profiles, criminal history or records, civil litigation history or records, educational records, (including GPA), Social Security records, past and current employment history or records, DMV or driving records and police clearance or good conduct letters.
I certify that placing my name below shall serve as my signature of acknowledgement and understanding.
 
Name:   Date:  
       

This release expires no later than 30 days from the date of signature, indicated above.