Section 5: Verification of Application and FCRA Disclosure Statement
APPLICATION VERIFICATION AND FCRA DISCLOSURE AND AUTHORIZATION
In connection with your employment or application for employment (including an application to enter into an owner operator lease agreement) with Yarbrough Transfer Company (“YTC”), YTC and its authorized employees and agents may request and obtain certain consumer and/or background reports, including, without limitation, reports regarding your employment history, education, licensing, criminal history, driving history, clearing house, character, abilities, citizenship status, experience, reasons for termination of past employment, and any other qualities that YTC deems pertinent to your fitness and qualifications for employment or lease with YTC (the “Reports”).
After making you a contingent offer of employment, YTC will require you to undertake federally-mandated medical and/or other physical evaluations to determine your fitness to perform the duties required by your employment or lease with YTC.
Under the Fair Credit Reporting Act, YTC is required to inform you if an adverse action is taken with respect to your application for employment or lease based in whole or in part on information contained in the Reports. YTC will provide you copies of any such Reports on which YTC based its decision in whole or in part, provided you make such request in writing. YTC is located and can be contacted by mail at:
Yarbrough Transfer Company
Attention: David Yarbrough
1500 Doune Street
Winston-Salem, NC 27127
YTC can be contacted by phone at (800) 334-0160. You may request more information about the nature and scope of the Reports, and the contact information of any consumer reporting agencies from whom YTC obtains Reports, by contacting YTC. A summary of your rights under the Fair Credit Reporting Act, which governs YTC’s use of the Reports in connection with your application for employment, is provided for you at https://www.consumer.ftc.gov/sites/default/files/articles/pdf/pdf-0096-fair-credit-reporting-act.pdf
Please complete and sign the Authorization and Release below, which, in summary, authorizes any or all parties including, without limitation, federal and state agencies (including the FMCSA, PSP Online Service, FMCSA Drug and Alcohol Clearinghouse, federal DOT, state DMV, federal and state DOC, and federal and state court systems), educational institutions, financial institutions, credit bureaus, current and former employers, and references to disclose to YTC and its authorized employees and agents any or all of the information described above.
Upon your request, a copy of this Authorization will be provided to you.
APPLICANT AUTHORIZATION TO OBTAIN CONSUMER AND BACKGROUND REPORTS
By electronically executing this authorization through checking the box and typing my full name and the date below, I hereby authorize YTC or its agents or employees to request and obtain Reports for the purpose of evaluating my fitness for employment or lease with YTC. I understand that if YTC hires me as an employee or enters into a lease agreement with me, my authorization and consent as evidenced herein will remain effective throughout the period of my employment or lease, and that YTC may request and obtain Reports throughout my employment or lease period for the purposes of evaluating my continued fitness for employment with YTC. I understand that Reports may include, without limitation, reports regarding my employment history, education, licensing, criminal history, driving history, character, abilities, citizenship status, experience, reasons for termination of past employment, and any other qualities that YTC deems pertinent to my fitness and qualifications for employment or lease with YTC. I further understand that Reports may be obtained through a variety of sources, including, without limitation, federal and state agencies (including the FMCSA, PSP Online Service, FMCSA Drug and Alcohol Clearinghouse, federal DOT, state DMV, federal and state DOC, and federal and state court systems), educational institutions, financial institutions, credit bureaus, current and former employers, and references. I understand that, upon written request to YTC, I will be informed whether Reports were requested and provided with information as to the nature and scope of the Reports. I understand that if an adverse action is taken with respect to my application for employment or lease, I may request copies of the Reports in writing, and YTC will provide me with copies of the Reports.
I agree to assist and cooperate with YTC’s investigation of my background, including providing all the necessary documents requested by YTC.
I understand that falsification of information on my application may disqualify me from employment or lease and that, if I am hired or leased by YTC, falsification of information on my application may result in termination of my employment or lease.
I HEREBY AUTHORIZE AND REQUEST THAT ANY AND ALL PARTIES WITH INFORMATION PERTINENT TO MY FITNESS OR QUALIFICATIONS FOR EMPLOYMENT WITH YTC, INCLUDING, WITHOUT LIMITATION, FEDERAL AND STATE AGENCIES (INCLUDING THE FMCSA, PSP ONLINE SERVICE, FMCSA DRUG AND ALCOHOL CLEARINGHOUSE, FEDERAL DOT, STATE DMV, FEDERAL AND STATE DOC, AND FEDERAL AND STATE COURT SYSTEMS), EDUCATIONAL INSTITUTIONS, FINANCIAL INSTITUTIONS, CREDIT BUREAUS, CURRENT AND FORMER EMPLOYERS, AND REFERENCES, TO FURNISH ANY AND ALL INFORMATION REGARDING ME THAT IS REQUESTED BY YTC AND/OR OTHER CONSUMER REPORTING AGENCIES HIRED BY YTC.
