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  • Consent Forms 2

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    james
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    31 visualizações10 páginas

    Consent Forms 2

    Enviado por

    james
    yes yes

    Direitos autorais:

    © All Rights Reserved
    Baixe no formato PDF ou leia online no Scribd
    Sinalizar o conteúdo como inadequado
    de 10
    Para informacion en espanol, visite www.consumerfinancegovflearnmore 0 escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, D.C, 20552. A Summary of Your Rights Under the Fair Credit Reporting Act ‘The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of ration in the files of consumer reporting agencies. There are many types of consumer reporting including credit bureaus and specialty agencies (such as agencies that sell information about check riting histories, medical records, and rental history records). Here is a summary of your major rights under theFCRA. For more information, including information about additional wivw.consumerfinance.gov/learnmore or write to: Cons Street N.W., Washington, DC 20552. + You must be told if information 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 diselosure will be free. You are entitled 10 @ fiee file disclosure if: + a person has taken adverse action against you because of information in your eredit 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. ner Financial Protection Bureau, 1700 G In addition, all consumers are entitled fo one fice disclosure every 12 months upon request from each nationwide eredit bureau and from nationwide specialty consumer reporting agencies. See www.con werfinance.gov/learnmore for addi + 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 wwww.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, usvally 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 ageney may not report negative information that is more than seven yeats old, or bankruptcies that are more than 10 years old. + Access to your file is limited. A consumer reporting ageney 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 fo employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written conisent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/leammore. -PAGE 1 of 2- «© You may limit “prescreened” offers of credit and insurance you get based on information in yor credit report, Unsolicited “prescreened” offers for etedit 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 1-888-5-OPTOUT (1-888-567-8688). ‘+ You may seek damages from violators, Ifa 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 vietims and active duty military personnel have additional rights. For more nformation, visit www,consumerfinance.gov/leammore, 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 ights, contact: ‘YPE OF BUSINESS ‘CONTACT. Ta Dil, svings tations, and eet unions wit ol Conan Fanaa Prtetion Biseau Wilion wd her ates 19006 Sr AW. Washington, BC 20552 Such flies dare not tanks svingsasacnins or credit uninsalso |b, Fede Tade Commission; Consumer Response Ceter-FCRA, hou i nan To the CEP Washington,DC 20580 (37 382357 3 To the eient not ed oe aE ‘National banks, federal savings associstnns, sn fade branches and federal | a. Ofee of te Compsroler ofthe Comey ‘gence of fcigh tanks Customer Assistance Group 1301 MeKianoy Sect, Sue 3450, Hoastn, 1X 71010-9050 State member banks, bancies and agencies of frign banks (other than by, Peder Reserve Consumer Help Center federal ranches, feral genes, an sre Ste Branches of Foeign P.O Box 1200, Benks) commercial lending companies owned or cones by foreign tanks, | Minneapolis, MN 55480 ane eraniaions operating under seston 25 or 25A ofthe Federal Reserve At «. Nosmiber nse Banks, sed Slate Branches of Foreign Boks, and «, FDIC Consumer Response Center ined sate savings secon 100 Walnut Ses, ax 1 Kansas City, MO 6t106 4, orl Crit Unions 4, National Credit Union Administion ‘Onice of Consumer Protection (OCP) Division af Consumer Cerpliane an Odeach (OCCO) 1735 Duke Ses, Alesandria, VA 22514 Tones ‘Asst. Genel Coal fer Avitien Enfocenen & Process ‘vntion Consumer Detection Divison Departmen of Hansporiaon 1200 Neve Jersey Avene, SE Washington, DC 20590 FCs Sujet to ie Se Temporaon Board ‘Ofc of Precedings, Surane Tanspoaton Hoard Depurnent of Penspocaton B95 Stet SW ‘Weshingon, DC 26123. a $ret Sueno te asker ond Staipars As IT [Nearest Packers ng Stocgants Adanitalion ara Sipessor 6 Sinall Businss investmen Companies “Associ Deputy Administer fer Capital Access Une Staton Saal Benes: Adminiraton| 409 Third See, SW, th Foor Washington, bc 20116 7: Taka ad Dealers “Sevuiliss ad Exchange Com sion Too Fst, VE. Washingion, DC 20549, Feder Cand Danks Feel Tard ak Asoc Federal Inoreediats | Fac Credit Administion| Grit Bans on Production Ciel Asacations 1501 Farm Crit Drive Meter, VA 22102-5080 3, Rees, Finance Companies, and A Other Cellos Noted Above TFC Regional Otis for yin in ich Ue cele Ope ar ede Trade Commission’ Conse: Response Cer FCRA ‘Woshington, DC 20580, 677) 382-4857 -PAGE 2 of 2- ka Bank BAC ROUND CHECK AUTHORIZATION { authorize TD Bank, N.A. and its subsidiaries, parents, successors and affiliates (“the Company”) to order my background check. [understand that, as allowed by law, the Company may rely on this authorization to order additional background reports without asking me for my authorization again (1) during my employment, and (2) from any consumer reporting agency (“CRA”). also authorize all of the following to disclose fo the CRA and its agents all including but not limited to: my past or present employers; learning institutions, including colleges and universities; law enforcement and all other federal, state and local agencies; federal, state and focal courts; the military; credit bureaus; testing facilities; motor vehicle records agencies; and any other person, organization, or agency with any information ‘about or coneeming me. ‘The information that can be disclosed to the CRA and its agents ineludes, but is not limited to, information concerning my employment and earnings history, education, credit history, motor vehicle history, erfminal history, military service, professional credentials and licenses, and drug and alcohol test results. Additional information about your rights has been provided to you with review it BEFORE you sign. Background Check Authorization. Please Prine Name nt any Other Names Used Social Security Number (for identification purposes only) Date of Birth (for identifieation purposes only) Driver's License(s) Number(s) and State(s) Address, And Any Other States In Which You Have Lived in the Past 7 Years: Signature Date: (Month /Day/ Year) ‘THE REMAINDER OF THIS DOCUMENT IS INTENTIONALLY LEFT BLANK PLEASE PROCEED ‘TO THE NEXT DOCUMENT: THE STATE NOTICE ADDENDUM Internal = Page L of | - Version Date: 12/08/2015 Bank BAC! “TD Bank, N.A. and its subsidiaries, parents, successors and affiliates (the “Company”) may order a “consumer report” (a background report) on you in connection with your employment application, and if you are hited, or if you already work for the Company, may order additional background reports on you Tor employment purposes. ‘The background report may contain information concerning your character, general reputation, personal characteristics, mode of living, drug and alcohol test results, and eriminal history. Information may be obtained from private and public record sources, including but not limited fo, sanctions databases, court records and records from the Federal Bureau of Investigation (“FBP), ‘THE REMAINDER OF THIS DOCUMENT IS INTENTIONALLY LEFT BLANK PLEASE PROCEED ‘TO THE NEXT DOCUM ECK AUTHORIZATION Internal Page | of Version Date: 12/4/2015 nD Bank EDUCATIONAL, CIVIL AND ADMINIS TRATIVE RECORD INFORMATION {hereby provide the following information for the consideration of TD Bank, N.A. and its subsidiaries, parents, ssuceessors and affiliates (“the Company”) in connection with my application for employment with, and employment with the Company. Highest Level of Education Attained (Please list ouly the highest level eompleted) Name of School Attended: Resident Addresses For The Past 7 Years Street Address cay State ZipCode From To MoJYr. Molt Iyes, please provide details. | certify that the foregoing information in this document is true and cortect. 1 understand that if T submit false information to the Company, my application for employment may be rejected or, if already employed, I may be subject to discipline up to and including termination of employment. Name: Date: Signature: Internal = Page 1 of = Version Date: 12/08/2015 ‘TD Bank Investigation and Fingerpri Scope of Criminal Backgroun ting Instructions ‘TD Bank is required by federal banking laws to investigate the criminal background of all ofits applicants for employment, as vwell as some current employees. To comply with these laws, TD Bank utilizes fingerprinting as its preferred method for conducting such background investigations, as it is the most comprehensive and accurate procedure available for such purposes. TD Bank will use your fingerprints to investigate your criminal history records with the Federal Bureau of Investigation ("FBI"), criminal investigation bureau, and/or other government agencieslentities. Please see the instructions below. If you are unable to be fingerprinted and would like fo explore an alternative method by which your criminal background ean be investigated, please contact TD Bank's Human Resources Department. Applicant Instruetions for Obtaining Fingerprints ‘You must obtain your fingerprints within 5 business days of receiving your verbal offer from TD Bank. You will not be able to begin working for TD Bank until your fingerprint results have been received and reviewed, and you are cleared to start by Human Resources. Please follow the below instructions to identify an appropriate fingerprint facility, You will need fo make an appointment. You will receive instructions on any additional items you will need to bring with you to the facility. Scheduling your fingerprint appointment through First Advantage online or by phone. To schedule your flugerprint appointment online wellness fady.com/OH/Root/applicant Login 11: 00000 Password: TDb4567@ phone: To schedule y fingerprint appointm The First Advantage National Scheduling Center (NSC) at 877-848-2958 is available Monday through Friday between 8am and 8pm (ET) to schedule your fingerprint appointment. Please identify yourself as a 2D Bavtk applicant, You will be requested to provide the following: ‘Your legal name as listed on your Driver’s License Social security number (SSN is equied to complete the fingerprint sched) Home Address including eity, state and zip code Daytime phone # Zip code you would like your appotaiment nearest occa “The NSC will locate the appropriate site to complete your fingerprinting by searching within « 30-mile radius of the zip code ‘you provide. The Scheduler will make the appointment and provide you with the date/time, phone number and location. Do not forget (o bring the following to your appointment: (1A valid photo 1D (State issued driver's license or ID card, military ID or passport). 1 The National Scheduling Center phone number 877-848-2958. ding Conter immediate Internal Page 1 of2- Version Date: 12/4/2015 FBI Privacy Act Statement ty: The FBI's acquisition, preservation, and exchange of fingerprints and associated information is ‘generally authorized under 28 U.S.C. $34. Depending on the nature of your application, supplemental authorities include Federal statutes, State statutes pursuant to Pub. L. 92-544, Presidential Executive Orders, and federal. ing your fingerprints and associated information is voluntary; however, failure to do so may affect completion or approval of your application. Social Security Account Number (SSAN). Your SSAN is needed to keep records accurate because other people may have the same name and birth date. Pursuant to the Federal Privacy Act of 1974 (5 USC 552a), the requesting ‘agency is responsible for informing you whether disclosure is mandatory or voluntary, by whet statutory or other authority your SSAN is solicited, and what uses will be made of it. Executive Order 9397 also asks Federal agencies to use this number to help identify individuals in agency records. Principal Purpose: Certain determinations, such as employment, licensing, and security clearances, may be predicated on fingerprint-based background checks. Your fingerprints and associated information/biometeies may be provided to the employing, investigating, or otherwise responsible agency, and/or the FBI for the purpose of comparing your fingerprints to other fingerprints in the FIBI’s Next Generation Identification (NGI) system or its successor systems (ineluding civil, criminal, and latent fingerprint repositories) or other available records of the employing, investigating, or otherwise responsible agency. The FBI may retain your fingerprints and associated nformation/biometries in NGI after the completion of this application and, while retained, your fingerprints may continue to be compared against other fingerprints submitted to or retained by NGI. Routine Uses: During the processing of this application and for as long thereafter as your fingerprints and associated information/biometries are retained in NGI, your information may be disclosed pursuant to your consent, and may be disclosed without your consent as permitted by the Privacy Act of 1974 and all applicable Routine Uses as may be published at any time in the Federal Register, including the Routine Uses for the NGI system and the FBI’s Blanket Routine Uses, Routine uses include, but are not limited (, disclosures to: employi governmental or authorized non-governmental agencies responsible for employment, contracting licensing, security clearances, and other suitability determinations; local, state, tribal, or federal law enforcement agencies; criminal justice agencies; and agencies responsible for national security or public safety, 1 Additional Information: The requesting agency andor the agency conducting the application-investigation will provide you additional information pertinent to the specific circumstances of this application, which may include identification of other authorities, purposes, uses, and consequences of not providing requested information. In addition, any such agency in the Federal Executive Branch has also published notice in the Federal Register describing any systems(s) of records in which that agency may also maintain your revords, including the authorities, purposes, and routine uses for the system(s) Interval Page 2 of 2- Version Date: 12/04/2015 is Bank INVESTIGATIVE CONSUM! SCLOSURE ‘TD Bank, N.A. and its subsidiaries, parents, successors and affiliates (the “Company”) will order an “investigative consumer report” concerning you for employment purposes. An “investigative consumer report” is defined as “a consumer report ot portion thereof in which information on a consumer's character, general reputation, personal characteristics, or mode of living is obtained through personal interviews with neighbors, friends, or assoctates of the consumer reported on or with others with whoa he is acquainted ‘or who may have knowledge concerning any stich items of information.” ‘The investigative consumer report the Company will order concerning you will contain information concerning your character, general reputation, personal characteristics, and mode of living, obtained through personal interviews. You have the right to right to request the additional disclosures provided for under the Fair Credit Reporting Act, 15 USC. § 1681d(b), which reads as follows: ‘Any person who procures or causes to be prepared an investigative consumer report on aay consumer shall, upon writen request made by the consumer within a reasonable period of time after the receipt by him of the disclosure required by subseetion (a1) ofthis section, make @ complete and accurate disclosure of the nature and scope of the investigation requested. This disclosure shall be made in a writing mailed, or otherwise delivered, to the consumer not later than five days after the date on which the request for such disclosure was received from the ‘consumer or such report was fitst requested, whichever isthe later. You can make a written request for a complete and accurate disclosure of the nature and scope of the investigation requested, request a copy of the report, or request the name, address and telephone number of the nearest unit designated to handle inquiries of each consumer reposting agency iss investigative consumer report about you, by sending a letter or email to the following: TAServices(@td.com, You may also request and promptly receive from all stich consumer reporting agencies copies of any such investigative consumer reports. Further, attached a summary of your rights under the Fair Credit Reporting Act. By signing below, f authorize the Company to obtain an investigative consumer report concerning me, Printed Name: Internat ~ Page | of | - Version Date: 12/04/2015 ron 8850 Pre-Screening Notice and Cartification Request for th rn) the Work Opportunity Credit oven. 1451600 Ponchemsice’ | _alormation about Form 6950 and ts coparate insiuctlons Is at wnairs.goviformsB50. ‘Job applicant: Fil'in the lines below and check any boxes that apply. Complete only this side, Your name _ Social security aumtboe Strct adsreos whore you ive iy orton, stato, and Z1P cas County Totephone numbor Ifyou ae under age 40, enter your dato of bith (month, day, yoar) 4 [_] Chock here i you received a conditional certiication from the state worklorce agency (SWA) or a participating local ‘agency for tha work opportunity rect, 2 [check nere i any ofthe following statements apply to you. “Lam a member of a faily thal has received asslatance kom Temporary Assistance for Needy Families (TANF) for any 9 months dusty the past 18 months, ‘+ Tama veieran and a member af a family tha recived Supplemental Notion Assistance Program (SNAP) benofs (food stamps fr al feast a S-month period during the pest 18 months. ‘+ was referred hare by rehabition agony approved by the state, an employment network under the Ticket to Work progran, or the Department of Veterans Alfa. * Tam atleast age 18 but not ago 40 or oker and | am a membor of 9 family tha 1 Recelved SNAP bonofis (ood stamps) for tne past 6 months, oF Received SNAP benef (lod siamps) for a east 3a! the past S months, but is no longer age fo receive them. During tha past year, vas convicted of a felony or relzaeed kam prison fora felony. + racoived supplemental secuiy income (SSI) Denes for any month encling during the past 60 days. + Lam a veteran aad | was unemployed fr 2 pao or periods totaling a least 4 wooks but loss than 6 months during the past year 2 [7] check here if you are a veteran and you were unemployed for a period or periods totaling at feast 6 montis during the past year 4 ([) check neve it you are a voteran enttiad to compensation for a service-connected disability and you were discharged oF released from active duty athe U.S, Armed Forces during the pest yea, 5 (1 check here if you are a veteran entitled to compensation for a service-connected disability and you were unemployed for & period oF periods totaling atleast 6 months during tha past year. 6] check ty mentor iy tat Hecived Ta payent for alee he ost 18a, + ecsived TANF paymni or any T8sonhs being ao August 6, 1007, and be ees 18mont pode eginirg afer aque, 097, ona gum the oe? yor, oF + ‘Stoppod boing oligo for TANF pyar dng te pat 2 yoo because agers sae a edhe maximum tev hos payment cod bo mado ‘Signature—All Appicanis Must Sign ‘ae peat tei oseie alge fr ebvekcnatnt ts enloeren ble dy ss feed op, adil batestel oon, caret arcane Job applicants signature Date Far Prney ActandPapervark Reduction Act Nain, 5609002 Fem 6860 (Row 120) F osara01a aan [eeuscseeeeas oN Romande niente mnt mcnconne oe LS waren rpeountanimaniatey Se aes eran cas eae ace cea Friel eer pestitm hes aa ‘Seaton Plosta gat cnet a Wacker la ee Fistor Ts Lasttane ‘Stato Hewiy Wage Home Aas Gir Boe Toulon Fail ‘socal Sec ES art 2B® OS QOGO/9G GH 99OG9/QGOHG/OO OO GeOD 299 OO OOOH/OH OO O9O9/G00HG/O0 OO OGed 299 OB BOG9/GO OH G9O9/9OG08/OG OO B00 299 BG QBOOG/HH BH 0905/G0000/60 OO 0000 OOO BO YQOB/GH BH QGOG/9QOQG/QO OO OOOH G99 O8 QOOHGH/GH GG OHO5/9OOHH/HH OO OOOO ©O9 GO G8GOG0/9G OH OOOH) 9HHHH/HO OH OOOH BOY OG QOQQG/HH OH O009/HHOOO/HO OH OOOO BO® OH GOQO/HH OO YHOGO|HOOHO/HH OO OOOH G00 O89 G000'0H OO 0000'00000'O8 08 0606 ‘Under penny of pany ste Bal ifn | rosdod soe bl of ny Aentadp, fue canoe a compa. Thereby abate ie igen’ management ed fecal, sit, Tat nd eal gover agence: fo powiniarmatene ADE aor Sve Waffen gos {Gani tedtcnino and dorumert eget isda sed ste exch eas _Employoo Signature Date. "re yous warn of hS US. Aemed Forces? rane, YesO WoO |_V ys: Ae you endo rocnve mony payer fara senic-connaded dab? veO oO [BY ave you rcahos uemyloyont compenstton fos cmbngs call weak or mort pas yee? YO Neo ‘aw you resshed unenplojmarteomperatn er combined (ll of mans rr i pas yor? ved nO | wy yes: fa what tt i you cee bane? avo you ora omy mambo In yourhoueceld eciad Feed Sampeanylnovwihin alee TGmentia? [vexO neO | pg ye: Pinar Rec ony: Site Tle you prtcaedin a voatanlrbabialon poem? Ya O eo ites eeeccena: Stee Agency. Velen Admieaton: Talo Was O ve cous’ Home ‘iy: ‘Slt ‘Ne you manber fa fry Wol eared Woe (AEOC o TAN ec heen ed era, hung or varsearitnd® |v Woo. (tote 2 mentor longer gs lor Weta bacave ouhav colaco fee masinun Uino proc? w yee: Prey Reape SIE oases State: _ i you rash Surlomenst Secu ecto (SN within heat 0 days? yO wO | oa ‘No you arent recevig Do Suey stan dsb bones (9SONT yes0 tO | 5301 "ae you toon conded oa lary or vo ya eeaod dead sduscaton fre any? YerO to tyes We you eased or you tea wok relat prepa oansidon canter ihn he pas 12 oath? yesO to yes, nas is aPederter Sata coméaon? Fics Statz © Nene: (Oxon Adseston)

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