S:\CLERK\Boards, Commissions, and Council\Applications\Background Forms\FCRA Disclosure and Authorization 01.01.2013.docx Revised 1/1/2013
FAIR CREDIT REPORTING ACT DISCLOSURE & AUTHORIZATION
As an applicant for employment or a current employee of the City of Thornton, you are a consumer with rights under the
Fair Credit Reporting Act. When any of the following circumstances exist, the City of Thornton may choose to obtain and
use information contained in either a consumer report or an investigative consumer report from a consumer reporting
agency about you when: (1) considering your application for employment, (2) making a decision whether to offer you
employment, (3) deciding whether to continue your employment (if you are hired), or (4) making other employment-related
decisions directly affecting you.
For explanation purposes, a “consumer reporting agency” is a person or business which, for monetary fees, dues, or on a
cooperative nonprofit basis, regularly assembles or evaluates consumer credit information or other information on
consumers for the purpose of furnishing consumer reports to others, such as the City of Thornton.
A “consumer report” means any written, oral or other communication of any information by a consumer reporting agency
bearing on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics,
or mode of living which is used or expected to be used or collected in whole or in part for the purpose of serving as a
factor in establishing your eligibility for employment purposes.
An “investigative consumer report” means a consumer report or portion thereof in which information on your character,
general reputation, personal characteristics, or mode of living is obtained through personal interviews with your neighbors,
friends, associates or others with whom you are acquainted or who may have knowledge concerning any such items of
In the event an investigative consumer report is prepared, you may request, additional disclosures regarding the nature
and scope of the investigation requested as well as a written summary of your rights under the Fair Credit Reporting Act.
By signing below, I, , hereby voluntarily authorize the City of Thornton to
obtain either a consumer report or an investigative consumer report about me from a consumer reporting agency and to
consider this information when making decisions regarding my employment at the City of Thornton.
I understand that I have rights under the Fair Credit Reporting Act, including the rights discussed above. In accordance
with the Fair Credit Reporting Act, if my employment is denied, based on information contained in a consumer report or
investigative consumer report from a consumer reporting agency, the City of Thornton will so advise me and will supply
the name and address of the consumer reporting agency making the report.
If I am employed by the City of Thornton this authorization shall remain in effect as long as I am an employee.
I acknowledge that I have received and read this Fair Credit Reporting Act Disclosure and Written Authorization
IF UNDER 18 YEARS OF AGE , PARENTAL CONSENT IS NECESSARY
We (I) hereby grant consent to the City of Thornton to conduct a consumer report or an investigative consumer report on
the above named individual as a part of the job application process and thereafter as warranted based on City of Thornton
policy in the event the above named individual is employed by the City.
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