Human Resources, Revised August 2015
College of Graduate Studies
2801 W. Bancroft St., MS # 933
Phone (419) 530-
DISCLOSURE AND AUTHORIZATION FORM
TO OBTAIN CONSUMER REPORTS FOR EMPLOYMENT PURPOSES
Please Read Carefully Before Signing the Authorization
In considering you for employment and, if you are employed, in considering you for subsequent promotion,
assignment, reassignment, retention, or discipline, The University of Toledo may request and rely upon
one or more consumer reports or investigative consumer reports about you that we obtain from a
consumer reporting agency, such as IntelliCorp Records, Inc.
IntelliCorp Records, Inc. can be contacted by mail at 3000 Auburn Dr, Suite 410; Beachwood, OH 44122;
or phone: 1-888-946-8355; or website: www.intellicorp.net.
For explanation purposes:
x a “consumer report” is a 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 making an employment-
related decision about you. Such information may include, for example, credit information, criminal
history reports, or driving records; and
x an “investigative consumer report” is a consumer report in which information on your character,
general reputation, personal characteristics, or mode of living is obtained through personal
interviews with your prior employers, neighbors, friends, or associates, or with others who may
have knowledge concerning any such items of information. In the event an investigative consumer
report is requested about you, you are entitled to 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 (“FCRA”).
Under the FCRA, before the Company can obtain a consumer report or investigative consumer report
about you for employment purposes, we must have your written authorization. Before we take adverse
action on the basis, in whole or in part, of information in that report, you will be provided a copy of that
report, the name, address, and telephone number of the consumer reporting agency, and a summary of
your rights under the FCRA.