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I certify that I personally completed this application
and that all of the information is true and correct.
I hereby request and authorize ATS to cause to be conducted,
at any time, an investigation of my background for employment
purposes, which may include, but is not limited to,
any information relating to my character, general reputation,
personal characteristics, criminal history, past work
experience, educational background, alcohol or drug
test results, or failure to submit to an alcohol or
drug test, or any other information about me which may
reflect upon my potential for employment gathered from
any individual, organization, entity, agency, or other
source which may have knowledge concerning any such
items of information. I have completed this application
of my own free will and hold ATS harmless of all liability
for providing this application for my use.
In connection with my application for certification
(including contract for services) with you, I understand
that consumer reports which may contain public record
information may be requested from DAC Services, Tulsa,
Oklahoma. These reports may include the following type
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
driving record, workers compensation claims, credit,
bankruptcy proceedings, criminal records, etc., from
federal, state and other agencies which maintain such
records; as well as information from DAC concerning
previous driving record requests made by others from
such state agencies, and state provided driving records.
I AUTHORIZE, WITHOUT RESERVATION, ANY PARTY OR AGENCY
CONTACTED BY ATS TO FURNISH THE ABOVE-MENTIONED INFORMATION.
I have the right to make a request to DAC, 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 DAC has previously
furnished within the two year period preceding my request.
I hereby consent to your obtaining the above information
from DAC, and I agree that such information which DAC
has or obtains, and my employment history with you if
I am hired, will be supplied by DAC to other companies
which subscribe to DAC Services.
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.
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