DISCLOSURE TO OBTAIN BACKGROUND INFORMATION
This is to inform you that as part of Georgia Nut Company’s procedure for processing your employment application, and/or in the event that you become employed, at any time while you are employed, Georgia Nut Company may obtain from a consumer reporting agency, a consumer report, or an investigative consumer report containing financial and other information about you. Georgia Nut Company may obtain one or more consumer reports regarding you from one or more consumer agencies and may use the report(s) for the purpose of evaluating you for employment, promotion, reassignment or retention as an employee. A “consumer report” is a communication of information by a consumer reporting agency bearing on a consumer’s credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living. An “investigative consumer report” may include information as to your character, general reputation, personal characteristics and mode of living, and this information may be obtained through personal interviews with your neighbors, friends, or associates or from others with whom you are acquainted or who may have knowledge concerning such items of information.

Georgia Nut Company complies with the Fair Credit Reporting Act (and applicable state law), which provides prospective or current employees with rights regarding consumer reports and places specific obligations on employers who obtain such reports. Georgia Nut Company will not obtain either a consumer report or an investigative consumer report without your signed authorization.

AUTHORIZATION TO PROCURE BACKGROUND INFORMATION
In connection with my application for employment with Georgia Nut Company and/or consideration for continuing employment, I understand that a consumer report or an investigative consumer report may be obtained by Georgia Nut Company from one or more consumer reporting agencies (“Agency”). A “consumer report” may contain information bearing on my character, general reputation, personal characteristics, mode of living, credit worthiness, credit standing, or credit capacity. An “investigative consumer report” is a consumer report which includes information obtained through personal interviews with my neighbors, friends, or associates, or others with whom I am acquainted or who may have knowledge concerning any such items of information.

I further understand that Georgia Nut Company may not request a consumer report from an Agency, nor may the Agency give out information about me, without my prior written consent. It is also understood that the Agency may not report medical information about me to Georgia Nut Company without my prior specific consent as to the release of such information, which is in addition to my general authorizations herein.

I hereby authorize Georgia Nut Company to order a consumer report or investigative consumer report containing financial and other information about me from a consumer reporting agency as part of its investigation into my application for employment or at any time while I am employed by Georgia Nut Company. This authorization does not include the release of medical information.

Additionally, I hereby acknowledge that I have read and understood the above Disclosure to Obtain Background Information Statement and received a copy of “A Summary of Your Rights Under the Fair Credit Reporting Act”.

I authorize LGL Internal Management Inc. and/or their agents to research my background as it pertains to application considerations. This may include verification of employment history (to include: position, dates, salary, reason ended, rehire eligibility, performance), education, licenses, and information contained in public records including credit, criminal, and motor vehicle data. I release all such persons from any liability or damages on account of having furnished such information. This reference is binding, now and in the future.
I authorize any and all law enforcement agencies to release to LGL Internal Management, Inc. and/or their agents, any information concerning me contained in the criminal history files and civil check.

A copy of this release form, including a fax copy, will be valid as an original hereof, even though that copy does not contain an original writing of my signature.

Menu