Applicant Cover Sheet Check List
I Understand that I Will be Required to Take a Pre-Employment Drug Test
I Consent to the Preparation of an Employment Background Report Regarding Me
Authorization to Obtain Employment Background Report
I have read the Disclosure Regarding Employment Background Report provided by
Demountable Concepts, Inc. and this Authorization to Obtain Employment Background Report.
By my signature below, I hereby consent to the preparation by Sterling Infosystems, Inc.
(“STERLING”), a consumer reporting agency located at 1 State Street, New York NY 10004,
(877) 424-2457, www.sterlinginfosystems.com, of background reports regarding me and the
release of such reports to Demountable Concepts, Inc. and its designated representatives, to
assist Demountable Concepts, Inc. in making an employment decision involving me at any time
after receipt of this authorization and throughout my employment, to the extent permitted by law.
To this end, I hereby authorize, without reservation, any state or federal law enforcement
agency or court, educational institution, motor vehicle record agency, credit bureau or other
information service bureau or data repository, or employer to furnish any and all information
regarding me to STERLING and/or Demountable Concepts, Inc. itself, and authorize STERLING
to provide such information to Demountable Concepts, Inc. I agree that a facsimile (“fax”),
electronic or photographic copy of this Authorization shall be as valid as the original.
I acknowledge receipt of a copy of the Consumer Financial Protection Bureau’s “ASUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT.”
California, Massachusetts, Minnesota, New Jersey and Oklahoma Applicants Only:
Please check the box to the left if you would like a free copy of any REPORT obtained by
Demountable Concepts, Inc. from Sterling.