ࡱ> &(#$% [bjbjo>o> 4` T T||$$$$$$$$8"%%$$'''''6)P) \)$<R79$d)6)6)d)d)7$$''HpDDDd)$'$'Dd)DDJo' 56@ B0KB8$Md)d)Dd)d)d)d)d)77Dd)d)d)d)d)d)d)d)d)d)d)d)d)d)d)d)| #: DISCLOSURE FOR BACKGROUND CHECK [Insert Company Name] (the Company) will procure a consumer report and/or investigative consumer report on you in connection with your application for employment, volunteer service, or a contracted position, including promotion or retention as an employee, volunteer or independent contractor, as applicable. TalentWise Inc., a consumer reporting agency, will obtain the report for the Company. Further information regarding TalentWise, including its privacy policy, may be found online at  HYPERLINK "http://www.TalentWise.com" www.TalentWise.com. TalentWise is located at 4511 Rockside Road, 4th Floor, Independence, OH 44131, and can be reached at (877) 982-9888. The report may contain information bearing on your character, general reputation, personal characteristics, mode of living and/or credit standing. The information that may be included in your report include: social security number trace, authorization to work checks, criminal records checks, civil record checks, financial information and credit checks (Experian U.S. Credit), federal record checks, public court records checks, driving records checks, drug tests, physical tests, educational records checks, employment history verification, references checks, sanction, licensing and certification checks. The information contained in the report will be obtained from private and/or public record sources, including sources identified by you in your job application or through interviews or correspondence with your past or present coworkers, neighbors, friends, associates, current or former employers, educational institutions or other acquaintances. You have the right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report from the Company. AUTHORIZATION FOR BACKGROUND CHECK I have carefully read and understand the separate background check disclosure document and the below authorization form. I have received a copy of the Summary of Your Rights Under the Fair Credit Reporting Act and any applicable state or local notices of rights provided with these documents. I have had the opportunity to review my rights. By my signature below, I consent to the preparation of background reports by TalentWise, and to the release of such reports to the Company and its designated representatives for the purpose of assisting the Company in making a determination as to my eligibility for employment, promotion, retention, contract assignment or for other lawful purposes. I understand that, to the extent allowed by law, information contained in my job application or otherwise disclosed to the Company by me before or during my employment or contract assignment, if any, may be utilized for the purpose of obtaining such consumer reports and/or investigative consumer reports about me. I understand that nothing herein shall be construed as an offer of employment or contract for services. I hereby authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal/state/local), motor vehicle record agencies, my past or present employers, the military, and other individuals or sources to furnish any and all information on me that is requested by the consumer reporting agency. By my signature (including electronic) below, I certify the information provided on and in connection with this form is true, accurate, and complete. I agree that this form in original, faxed, photocopied or electronic form will be valid for any background reports that may be requested by or on behalf of the Company. First Name: Full Middle Name: Last Name: Signature: Date: CALIFORNIA, MASSACHUSETTS, MINNESOTA, NEW JERSEY, and OKLAHOMA applicants or residents: You have a right to request a free copy of your report. Please check here if you would like [Insert Company Name] to provide you with a copy of your report. A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT Para informacin en espaol, visite www.consumerfinance.gov/learnmore o escriba a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552. The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552. You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment or to take another adverse action against you must tell you, and must give you the name, address, and phone number of the agency that provided the information. You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your file disclosure). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if: a person has taken adverse action against you because of information in your credit report; you are the victim of identity theft and place a fraud alert in your file; your file contains inaccurate information as a result of fraud; you are on public assistance; you are unemployed but expect to apply for employment within 60 days. In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information. You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender. You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures. Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate. Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old. Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access. You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to  HYPERLINK "http://www.consumerfinance.gov/learnmore" www.consumerfinance.gov/learnmore. You may limit prescreened offers of credit and insurance you get based on information in your credit report. Unsolicited prescreened offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-567-8688. You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court. Identity theft victims and active duty military personnel have additional rights. For more information, visit  HYPERLINK "http://www.consumerfinance.gov/learnmore" www.consumerfinance.gov/learnmore. States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. For information about your federal rights, contact: TYPE OF BUSINESS:CONTACT:1.a. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates.a. Consumer Financial Protection Bureau 1700 G Street NW Washington, DC 20552b. Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the CFPB:b. Federal Trade Commission: Consumer Response Center FCRA Washington, DC 20580 (877) 382-43572. To the extent not included in item 1 above:a. National banks, federal savings associations, and federal branches and federal agencies of foreign banksa. Office of the Comptroller of the Currency Customer Assistance Group 1301 McKinney Street, Suite 3450 Houston, TX 77010-9050b. State member banks, branches and agencies of foreign banks (other than federal branches, federal agencies, and Insured State Branches of Foreign Banks), commercial lending companies owned or controlled by foreign banks, and organizations operating under section 25 or 25A of the Federal Reserve Actb. Federal Reserve Consumer Help Center P.O. Box 1200 Minneapolis, MN 55480c. Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associationsc. FDIC Consumer Response Center 1100 Walnut Street, Box #11 Kansas City, MO 64106d. Federal Credit Unionsd. National Credit Union Administration Office of Consumer Protection (OCP) Division of Consumer Compliance and Outreach (DCCO) 1775 Duke Street Alexandria, VA 223143. Air carriersAsst. General Counsel for Aviation Enforcement & Proceedings Aviation Consumer Protection Division Department of Transportation 1200 New Jersey Avenue, SE Washington, DC 205904. Creditors Subject to Surface Transportation BoardOffice of Proceedings, Surface Transportation Board Department of Transportation 395 E Street S.W. Washington, DC 204235. Creditors Subject to Packers and Stockyards Act, 1921Nearest Packers and Stockyards Administration area supervisor6. Small Business Investment CompaniesAssociate Deputy Administrator for Capital Access United States Small Business Administration 409 Third Street, SW, 8th Floor Washington, DC 204167. Brokers and DealersSecurities and Exchange Commission 100 F St NE Washington, DC 205498. Federal Land Banks, Federal Land Bank Associations, Federal Intermediate Credit Banks, and Production Credit AssociationsFarm Credit Administration 1501 Farm Credit Drive McLean, VA 22102-50909. Retailers, Finance Companies, and All Other Creditors Not Listed AboveFTC Regional Office for region in which the creditor operates or Federal Trade Commission: Consumer Response Center FCRA Washington, DC 20580 (877) 382-4357 ADDITIONAL STATE LAW NOTICES CALIFORNIA, MASSACHUSETTS, MINNESOTA, NEW JERSEY, AND OKLAHOMA applicants or residents: You have a right to request a free copy of your report. CALIFORNIA: Pursuant to section 1786.22 of the California Civil Code, you may contact TalentWise during normal business hours (9am to 5pm PST, Monday through Friday) to obtain and review all information in your file. You may obtain such information by appearing in person at TalentWises offices, during normal business hours and upon reasonable notice, and upon submitting proper identification and paying the costs duplication services. You may be accompanied by one other person, provided that person furnishes proper identification. You may also obtain a copy of your file by certified mail, if you have previously provided identification in a written request that your file be sent to you or a third party identified by you. You may also obtain a summary of your file by telephone, upon providing proper identification. TalentWise has trained personnel available to explain your file to you, including any coded information. CALIFORNIA (En Espaol): De acuerdo con el artculo 1786.22 del Cdigo Civil, Usted puede llamar a TalentWise durante los horarios normales de trabajo (9 de la maana a 5 de la tarde, tiempo del pacfico, lunes a viernes) para obtener y examinar su archivo privado en detalle. Para conseguir una copia de su archivo privado, puede hacer una visita en persona a la oficina de TalentWise durante los horarios normales de trabajo, dando aviso razonable, presentando identificacin apropiada, y pagando los costos de duplicacin. Otra persona puede acompaarle con tal que tambin traiga identificacin apropiada. Usted puede pedirnos que le mandemos por correo certificado una copia de su archivo privado con tal que hayamos recibido una solicitud escrita indicando que le mandemos una copia de su archivo privado a Usted o a un tercero que est identificado por Usted. Tambin puede pedir por telfono un resumen de su archivo privado, al presentarnos identificacin apropiada. TalentWise emplea trajabadores cualificados, quienes estn disponibles para explicarle el contenido de su archivo privado, incluyendo cualquier dato cifrado. CALIFORNIA [SAN FRANCISCO/ENGLISH]: Post where readily accessible to job applicants and employees. CITY AND COUNTY OF SAN FRANCISCO EDWIN M. LEE, MAYOR NOTICE TO JOB APPLICANTS AND EMPLOYEES San Francisco Fair Chance Ordinance Police Code, Article 49 Starting August 13, 2014, the Fair Chance Ordinance (San Francisco Police Code, Article 49) requires employers to follow strict rules regarding the use of arrest and conviction records in hiring and employment decisions. The ordinance covers job applicants and employees who would be or are performing work in whole, or in substantial part, in San Francisco and applies to employers who have 20 or more employees (regardless of the employees locations). Certain matters are off-limits. An employer may never ask about, require disclosure of, or consider: an arrest not leading to a conviction (other than an unresolved arrest that is still undergoing criminal investigation or trial); participation in a diversion or deferral of judgment program; a conviction that has been expunged or made inoperative; any determination in the juvenile justice system; a conviction more than 7 years old; and a criminal offense other than a felony/misdemeanor. Matters that are off-limits cannot be used by the employer for any reason at any stage of the hiring process. An employer cannot ask about an individuals conviction history or unresolved arrests at the start of the hiring process. This includes through a job application form, informal conversation, or otherwise. A mandatory interactive process for matters not off-limits. Only after a live interview has been conducted, or a conditional offer of employment made, is the employer allowed to ask about an individuals conviction history (except as to matters that are off-limits) and unresolved arrests. Only those convictions and unresolved arrests that directly relate to the individuals ability to do the job may be considered in making an employment decision. Before the employer may take an adverse action such as failing/refusing to hire, discharging, or not promoting an individual based on a conviction history or unresolved arrest, the employer must give the individual an opportunity to present evidence that the information is inaccurate, the individual has been rehabilitated, or other mitigating factors. The individual has seven days to respond, at which point the employer must delay any adverse action for a reasonable time and reconsider the adverse action. The employer must notify the individual of any final adverse action. Evidence of rehabilitation include satisfying parole/probation; receiving education/training; participating in alcohol/drug treatment programs; letters of recommendation; and age at which the individual was convicted. Mitigating factors include coercion, physical or emotional abuse, and untreated substance abuse/mental illness, that contributed to the conviction. No Retaliation. An employer may not take an adverse action against an applicant or employee for exercising their rights under the ordinance or cooperating with the Office of Labor Standards Enforcement OLSE. If you need more information, or wish to report an employer that you believe has violated this ordinance, please contact the OLSE at 415-554-5192 or email  HYPERLINK "mailto:FCE@sfgov.org" FCE@sfgov.org. OFFICE OF LABOR STANDARDS ENFORCEMENT City Hall, Room 430 1 Dr. Carlton B. Goodlett Place San Francisco CA 94102-4685 Tel. (415) 554-6235 Fax (415) 554-4791 CALIFORNIA [SAN FRANCISCO/SPANISH]: Publicar donde est accesible para quienes solicitan el empleo y los empleados. CIUDAD Y CONDADO DE SAN FRANCISCO EDWIN M. LEE, ALCALDE AVISO PARA LOS SOLICITANTES DE EMPLEO Y EMPLEADOS Ordenanza de Oportunidades Equitativas de San Francisco Cdigo de Polica, Artculo 49 A partir del 13 de agosto de 2014, la Ordenanza de Oportunidades Equitativas (Cdigo Policiaco de San Francisco, Artculo 49) requiere que los empleadores sigan reglas estrictas referentes al uso de los expedientes de arrestos y condenas al tomar decisiones de contratacin y empleo. La ordenanza cubre a los solicitantes de empleos y empleados que estaran o estn realizando su trabajo, o una parte sustancial del mismo, en San Francisco y se aplica a los empleadores que tengan 20 o ms empleados (sin importar la ubicacin de los empleados). Est prohibido tocar ciertos asuntos. Un empleador nunca puede preguntar, requerir la divulgacin de, o considerar: un arresto que no haya resultado en una condena (que no sea un arresto no resuelto que actualmente est bajo investigacin penal o juicio); participacin en un programa de justicia alternativa o de fallo diferido; una condena que haya sido cancelada o declarada inoperante; cualquier determinacin en el sistema de justicia juvenil; una condena de ms de 7 aos de antigedad; y una infraccin penal que no sea un delito mayor o delito menor. El empleador no puede utilizar los asuntos que estn prohibidos para ningn propsito, en ninguna etapa del proceso de contratacin. Un empleador no puede preguntar sobre el historial de condenas o de arrestos no resueltos de una persona al inicio del proceso de contratacin. Esto incluye preguntar mediante un formulario de solicitud de empleo, una conversacin informal o de otra forma. Un proceso interactivo obligatorio para asuntos que no estn prohibidos. Slo despus de que se haya hecho una entrevista en persona, o se haya hecho una oferta condicional de empleo, el empleador tiene permitido hacer preguntas sobre el historial de condenas de una persona (excepto sobre asuntos que estn prohibidos) y arrestos no resueltos. Slo se pueden tomar en cuenta las condenas y los arrestos no resueltos que directamente se relacionen con la capacidad de la persona para hacer el trabajo al tomar la decisin del empleo. Antes de que el empleador pueda tomar una accin adversa como no contratar, negarse a contratar, despedir, o no dar un ascenso a una persona con base en su historial de condenas o arrestos no resueltos, debe darle a la persona una oportunidad para presentar evidencia de que la informacin no es precisa, que la persona est rehabilitada, y otros factores atenuantes. La persona tiene 7 das para responder, en cuyo momento, el empleador debe posponer cualquier accin adversa durante un tiempo razonable y reconsiderar la accin adversa. El empleador debe avisar al individuo sobre cualquier accin adversa final. La evidencia de rehabilitacin incluye una libertad probatoria/bajo palabra satisfactoria; recibir educacin/capacitacin; participacin en programas de tratamiento contra alcohol/drogas; cartas de recomendacin; y la edad a la que la persona recibi la condena. Los factores atenuantes incluyen el chantaje, el maltrato fsico o emocional, y la enfermedad no tratada mental o de consumo de sustancias que hayan contribuido con la condena. Sin represalias. Un empleador no puede tomar una accin adversa contra un solicitante o empleado por ejercer sus derechos conforme a la ordenanza o por cooperar con la Oficina de Cumplimiento de los Estndares Laborales (Office of Labor Standards Enforcement, OLSE). Si usted necesita ms informacin, o si desea reportar a un empleador que usted crea que ha infringido esta ordenanza, por favor comunquese con la OLSE al 415-554-5192 o por correo electrnico a FCE@sfgov.org. OFFICE OF LABOR STANDARDS ENFORCEMENT City Hall, Room 430 1 Dr. Carlton B. Goodlett Place San Francisco CA 94102-4685 Tel. (415) 554-6235 Fax (415) 554-4791 CALIFORNIA [SAN FRANCISCO/TAGALOG]: Ipaskil kung saan madaling mabasa ng mga aplikante ng trabaho at mga kawani. LUNGSOD AT COUNTY NG SAN FRANCISCO EDWIN M. LEE, MAYOR PASABI SA MGA APLIKANTE NG TRABAHO AT MGA KAWANI Ordinansa ng Makatarungang Pagkakataon ng San Francisco (San Francisco Fair Chance Ordinance) Police Code, Article 49 Simula ng Agosto 13, 2014, ang Ordinansa ng Makatarungang Pagkakataon (Fair Chance Ordinance) (San Francisco Police Code, Article 49) ay nag-uutos sa mga may-ari ng negosyo na mahigpit na sundin ang mga alituntunin tungkol sa paggamit ng mga talaan sa pagdakip at paghatol ng pagkakasala sa mga desisyon sa pagtanggap ng kawani at pagtatrabaho. Ang ordinansa ay sumasakop sa mga aplikante ng trabaho at mga kawani na magtatrabaho o nagtatrabaho sa kabuuan, o sa mahalagang bahagi, sa San Francisco at umiiral sa mga may-ari ng negosyo na may 20 o higit pang kawani (sa kabila ng mga lugar na kinaroroonan ng mga kawani). Ang ilang mga bagay ay pinagbabawal. Ang may-ari ng negosyo ay hindi kailanman maaaring magtanong, mangailangan ng pagbubunyag, o isaalang-alang ang tungkol sa: pagdakip na hindi nagresulta sa paghatol ng pagkakasala (maliban sa hindi pa nalulutas na pagdakip na sumasailalim pa ng kriminal na imbestigasyon o paglilitis); paglahok sa programa ng isang paglihis o pagliban ng paghatol; paghatol ng pagkakasala na binura o hindi ipinatupad; anumang pagpapasiya sa sistema ng katarungang pangkabataan; paghatol ng pagkakasala na mahigit sa 7 taon; at kriminal na pagkakasala maliban sa krimen/maliit na kasalanan. Ang mga bagay na pinagbabawal ay hindi maaaring gamitin ng employer para sa anumang dahilan at anumang bahagi ng proseso ng pagtanggap ng kawani. Ang may-ari ng negosyo ay hindi maaaring magtanong sa indibiduwal tungkol sa kasaysayan ng paghatol ng pagkakasala o hindi pa nalulutas na mga pagdakip sa simula ng proseso ng pagtanggap ng kawani. Kabilang dito ang paggamit sa pormularyo ng aplikasyon sa trabaho, hindi pormal na pakikipag-usap, o ng iba pang paraan. Ang inuutos na interaktibong proseso para sa mga bagay na hindi pinagbabawal. Pagkatapos lamang na magsagawa ng personal na panayam, o magbigay ng may-kondisyong alok ng pagtatrabaho, ang employer ay pinapahintulutang magtanong sa indibiduwal tungkol sa kasaysayan ng paghatol ng pagkakasala (maliban sa mga bagay na pinagbabawal) at hindi pa nalulutas na mga pagdakip. Iyon lamang mga paghatol ng pagkakasala at hindi pa nalulutas na mga pagdakip na tuwirang may-kaugnayan sa kakayahan ng indibiduwal na gawin ang trabaho ang maaaring isaalang-alang sa paggawa ng desisyon sa pagtatrabaho. Bago maaaring gumawa ng kasalungat na aksiyon ang employer gaya ng pagbagsak/pagtangging tanggapin sa trabaho, pagpapaalis, o hindi pagtataas ng tungkulin ng indibiduwal batay sa kasaysayan ng paghatol ng pagkakasala o hindi pa nalulutas na pagdakip, ang employer ay dapat bigyan ng pagkakataon ang indibiduwal na magharap ng ebidensiya na ang impormasyon ay hindi wasto, na ang indibiduwal ay dumaan na sa rehabilitasyon, o iba pang nakakababang mga dahilan. Ang indibiduwal ay may pitong araw upang tumugon, na kung saan ang employer ay dapat ipagpaliban ang anumang kasalungat na aksiyon sa loob ng makatwirang panahon at muling isaalang-alang ang kasalungat na aksiyon. Ang employer ay dapat ipabatid sa indibiduwal ang anumang panghuling kasalungat na aksiyon. Kabilang sa ebidensiya ng rehabilitasyon ay ang kasiya-siyang parol/pansamantalang pagpapalaya (probation); pagtanggap ng edukasyon/pagsasanay; paglahok sa mga programa ng paggamot ng alkohol/druga; mga sulat ng rekomendasyon; at edad nang nahatulan ang indibiduwal. Kabilang sa nakakababang mga dahilan ay pananakot, pisikal o emosyonal na pag-abuso, at hindi pa nagagamot na pag-abuso sa substansiya/sakit pangkaisipan, na naging dahilan sa paghatol ng pagkakasala. Walang Pagganti. Ang may-ari ng negosyo ay hindi maaaring gumawa ng kasalungat na aksiyon laban sa aplikante o kawani dahil sa pagganap ng kanilang mga karapatan sa ilalim ng ordinansa o pakikipag-tulungan sa Office of Labor Standards Enforcement (OLSE). Kung kailangan pa ninyo ng higit na impormasyon, o nais mag-ulat ng employer na sa palagay ninyo ay lumabag sa ordinansang ito, mangyaring kontakin ang OLSE sa 415-554-5192 o email FCE@sfgov.org. OFFICE OF LABOR STANDARDS ENFORCEMENT City Hall, Room 430 1 Dr. Carlton B. 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$da$gd$;9f{ƎXYq('lmʗ֗VvABQ]^lʜ 9˟̟0νww h hSbCJOJQJ^JaJ#h h z5CJOJQJ^JaJ#h h3K5CJOJQJ^JaJ h h3KCJOJQJ^JaJ h h zCJOJQJ^JaJh h3K5CJ^JaJ h hB1CJOJQJ^JaJ#h hB1>*CJOJQJ^JaJ+z{ǎXYqđ7h: & F0^`0gd$;: & F^gd$;:gd$; $da$gd$;;$a$gd$;(lm˗ABQ]^l 9˟̟9 & F^gd$;: & F^gd$;:gd$; :^gd$;1OPQ_ $7$8$Ifgd $$7$8$Ifa$gd  & Fd7$8$^`gd z$d7$8$a$gd$;: & F^gd$;:gd$; OPQ^HIcdj˻teM=0=h zh zCJ^JaJh zh z5CJ\^JaJ.jh h0J&B*CJU^JaJphh h0J&CJ^JaJh hCJaJjh hCJUaJh hCJ^JaJh h5CJ\^JaJh h5CJ\^JaJh h3K5CJ\^JaJ h h CJOJQJ^JaJ h h3KCJOJQJ^JaJ#h h3K>*CJOJQJ^JaJjkkl "#tƶxhXxhxIAhCCJaJjh hCJUaJh h z5CJ\^JaJh h5CJ\^JaJh h5CJ\^JaJh h zCJ^JaJh hCJ^JaJh zh zCJ^JaJ hh zh zh z5CJ\^JaJ4jh zh z0J&5B*CJU\^JaJph"h zh z0J&5CJ\^JaJh zjh zUkl e}}}}}}] $ & F h8d7$8$^8`a$gd$;$d7$8$a$gd$; & Fd7$8$^`gd zYkd$$If0$FF" t622 4Bayt eUxy/0devw,-OP$d7$8$a$gd$;$d7$8$^a$gd$;$ & F8d7$8$^8`a$gd$;tuv34WXΰϰxy/0devw,Ϸ}rϷrϷbUUUUUh h zCJ^JaJh h z5CJ\^JaJh hCJaJh h5CJ\^JaJh h5CJ\^JaJh\5CJ\^JaJh hCJ^JaJ.jh h0J&B*CJU^JaJphh h0J&CJ^JaJjh hCJUaJ#jh hCCJUaJ!,-OPefgpruÿȿG淬ugZI8I8I!h hla#B*CJ^JaJph!h hdB*CJ^JaJphh haCJ^JaJh ha5CJ^JaJh h z5CJ\^JaJ.jh h0J&B*CJU^JaJphh h0J&CJ^JaJh hCJaJjh hCJUaJh h5CJ\^JaJh h5CJ\^JaJh hCJ^JaJh h zCJ^JaJPefg?@P+$ & Fd7$8$H$a$gd$;$ & Fd7$8$H$a$gd$;$d7$8$H$a$gd$*$d7$8$H$a$gd$;$d7$8$a$gd$;Gbfkpwx1/#4 "pʺ󤖉|hP/jh h&5>*CJOJQJU^JaJ&h h&5>*CJOJQJ^JaJh h&CJ^JaJh h&CJ^JaJh h&5CJ^JaJ hA#^Jh h)2t5CJ\^JaJh ha5CJ\^JaJh ha5CJ\aJh ha5CJ^JaJh hla#CJ^JaJh haCJ^JaJ1i?W"#7$ & F d7$8$H$a$gd$;$ & F d7$8$H$a$gd$;$d7$8$H$a$gd$;$ & Fd7$8$H$a$gd$;7XXRYSY&Z'Z[6gd& 7$a$gd& $da$gd&$d7$8$H$a$gd$;$ & F d7$8$H$a$gd$;<=st;prXXXSYYYYYYYYZZ'Z{Z[[쬜||i$hA#hA#CJOJPJQJ^JaJ h h&CJ^JaJmHsHUh h&CJ^JaJh h&5CJ\^JaJ&h h&CJOJQJ\]^JaJ'h h&0J&5CJOJQJ^JaJ/jh h&5>*CJOJQJU^JaJ&h h&5>*CJOJQJ^JaJ(: Attorney Generals Office Consumer Resource Center, 900 Fourth Avenue, Suite 2000, Seattle, WA 98164-1012, Phone: (206) 464-6684, Fax: (206) 464-645. Spokane (Northeast Washington): Attorney Generals Office Consumer Resource Center, 1116 West Riverside, Spokane, WA 99201-1194, Phone: (509) 456-3123, Fax: (509) 458-3548. Tacoma (Pierce, Mason, Grays Harbor, Kitsap and South King Counties): Attorney Generals Office Consumer Resource Center, P.O. Box 2317, Tacoma, WA 98401-2317, Phone: (253) 593-2904, Fax: (253) 593-2449. Vancouver (Clark, Cowlitz, Pacific, Skamania, Wahkiakum, Lewis and ThurstonCounties): Attorney Generals Office Consumer Resource Center, 1220 Main Street, Suite 549, Vancouver, WA 98660-2964, Phone: (360) 759-2150, Fax: (360) 759-2159.      SAMPLE ONLY -NOTHING HEREIN SHOULD BE CONSTRUED AS LEGAL ADVICE OR COUNSEL. YOU SHOULD CONSULT WITH YOUR OWN COUNSEL ABOUT YOUR COMPLIANCE RESPONSIBILITIES UNDER THE FCRA AND STATE LAW. 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