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108.916 -18 Td (Fair Credit Reporting Act \(FCRA\)) Tj
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-155.903 -27.955 Td (A required component of your investigation for employment in a moderate or high risk position or National Security) Tj
0 -11.999 Td (Clearance is an inquiry with a credit bureau. Under the provisions of the Fair Credit Reporting Act \(15 § U.S.C. 1681 b\),) Tj
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36.666 544.513 Td (The attached ) Tj
/F0 10 Tf (Disclosure and Authorization Pertaining to Consumer Reports Pursuant to the Fair Credit Reporting) Tj
0 -11.999 Td (Act ) Tj
/F1 10 Tf (must be signed so we can conduct an inquiry with a credit bureau and complete your investigation. Failure to) Tj
0 -11.999 Td (complete this form and comply with the investigative requirements for the position you currently occupy or have been) Tj
0 -11.999 Td (selected for could result in disciplinary action, up to and including removal. If the Department of the Treasury intends to) Tj
0 -11.999 Td (take any adverse action based in whole or in part on your credit report, you are entitled to certain protections set out in the) Tj
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9.995 46.647 Td ("a clear and conspicuous disclosure has been made in writing to the consumer at any time before the) Tj
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229.64 461.571 Td (A Summary of Your Rights) Tj
-2.015 -11.891 Td /F1 10 Tf (Under the Fair Credit Reporting Act) Tj
-189.788 -26.382 Td (The federal Fair Credit Reporting Act \(FCRA\) is designed to promote accuracy, fairness, and privacy of information in the) Tj
0 -11.469 Td (files of every “consumer reporting agency” \(CRA\). Most CRAs are credit bureaus that gather and sell information about) Tj
0 -11.469 Td (you -- such as if you pay your bills on time or have filed bankruptcy -- to creditors, employers, landlords, and other) Tj
0 -11.469 Td (businesses. You can find the complete text of the FCRA in 15 U.S.C. §§ 1681-1681u. The FCRA gives you specific) Tj
0 -11.469 Td (rights, as outlined below. You may have additional rights under state law. You may contact a state or local consumer) Tj
0 -11.469 Td (protection agency or a state attorney general to learn those rights.) Tj
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15.163 -24.038 Td (You must be told if information in your file has been used against you.) Tj
/F1 10 Tf ( Anyone who uses information from a) Tj
0 -11.469 Td (CRA to take action against you -- such as denying an application for credit, insurance, or employment -- must tell you,) Tj
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0 -25.036 Td (You can find out what is in your file.) Tj
/F1 10 Tf ( At your request, a CRA must give you the information in your file, and a list of) Tj
0 -11.469 Td (everyone who has requested it recently. There is no charge for the report if a person has taken action against you) Tj
0 -11.469 Td (because of information supplied by the CRA, if you request the report within 60 days of receiving notice of the action.) Tj
0 -11.469 Td (You also are entitled to one free report every twelve months upon request if you certify that \(1\) you are unemployed) Tj
0 -11.469 Td (and plan to seek employment within 60 days, \(2\) you are on welfare, or \(3\) your report is inaccurate due to fraud.) Tj
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/F1 10 Tf ( If you tell a CRA that your file contains inaccurate) Tj
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0 -11.469 Td (The CRA must give you a written report of the investigation and a copy of your report of the investigation results in) Tj
0 -11.469 Td (any change. If the CRA’s investigation does not resolve the dispute, you may add a brief statement to your file. The) Tj
0 -11.469 Td (CRA must normally include a summary of your statement in future reports. If an item is deleted or a dispute statement) Tj
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307.346 423.995 Td ( Please contact:) Tj
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/F1 10 Tf ( If you tell anyone -- such as a creditor who) Tj
0 -11.469 Td (reports to a CRA -- that you dispute an item, they may not then report the information to a CRA without including a) Tj
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0 -17.649 Td (Outdated information may not be reported.) Tj
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0 -21.566 Td (Access to your file is limited.) Tj
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0 -20.546 Td (You may choose to exclude your name from CRA lists for unsolicited credit and insurance offers. Creditors) Tj
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0 -11.469 Td (Such offers must include a toll-free phone number for you to call if you want your name and address removed from) Tj
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0 g 36.986 148.394 Td (This form is in compliance with the Privacy Act of 1974. Our authorized right to ask for this information is 5 U.S.C. 301 and Executive Order 10450,) Tj
0 -9.176 Td (which established the criteria for sensitive Government positions. The information you supply by signing this release of information form will be used) Tj
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0 -1.670 Td 0 -16.682 Td (Your signature on this release is voluntary; however, your failure to complete this form may mean that the required information cannot be obtained to) Tj
0 -9.176 Td (complete your investigation. This may affect your placement or security clearance prospects.) Tj
0 -1.670 Td 0 -16.682 Td (If the Department of the Treasury intends to take any adverse action based in whole or in part on your credit report, you are entitled to certain) Tj
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0.306 630.448 Td (This is a release for the Department of the Treasury to obtain one or more consumer/credit reports about you for an) Tj
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0 -2.086 Td 0 -20.852 Td (I, hereby) Tj
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2003-02-07T17:03:41-08:00
2003-02-07T17:03:41-08:00
Form 13340
FCAA
Sean Alec Mitchell
2003-02-07T17:03:41-08:00
2003-02-07T17:03:41-08:00
2003-02-07T17:03:41-08:00
Form 13340
FCAA
Sean Alec Mitchell
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