Employment Credit Check Authorization

EMPLOYMENT CREDIT CHECK AUTHORIZATION I authorize Weiss & Mueller, Ltd., or any other 3rd party, to obtain and or run a personal credit report on myself. I agree to hold Weiss & Mueller, Ltd. harmless regarding any information that is obtained during this credit check. I am aware that this report is prepared under the guidelines of the Fair Credit Reporting Act (FCRA) and I am eligible to receive, upon written request, a copy of the report, if not hired. Applicant: The request for your date of birth is to be used in performing a credit check only, and is not used by the client in consideration of employment. If you have a signed authorization, type your initials here Signature on file
CLIENT INFORMATION
Date:
Last Name:
First Name:
Middle Name:
Maiden Name:
Address:
City:
State:
Zip Code:
Social Security Number:
Date of Birth:
Client & Location:
Email: