Authorization Form
During the application process and at any time during the tenure of my employment with Hurst Farm Supply Inc., I hereby authorize ChoicePoint Services Inc., on behalf of Hurst Farm Supply Inc. to procure a consumer report (known as an investigative consumer report in California) which I understand may include information regarding my credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living. This report may be compiled with information from credit bureaus, court record repositories, departments of motor vehicles, past or present employers and educational institutions, governmental occupational licensing or registration entities, business or personal references, and any other source required to verify information that I have voluntarily supplied. I understand that I may request a complete and accurate disclosure of the nature and scope of the background verification, to the extent such investigation includes information bearing my character, general reputation, personal characteristics or mode of living.
Disclaimer and Signature
By electronically signing below and submitting this application to Hurst Farm Supply, you agree that: “I certify that the facts contained in this application for employment are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application or other supplementary material shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice. I understand that this application is only valid for ninety (90) days from the date signed below. If I want to be considered for job openings beyond ninety (90) days from date signed below, I agree to submit a new application.”
