Galaxy Holdings
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Name: Michael Yuan
Title: General Manager
Date:
Signature of applicant/employee
Date:
Galaxy Holdings (the “Company”) may obtain one or more consumer reports or investigative consumer reports about you, , for employment purposes, including hiring, retention, promotion, reassignment, or other lawful employment decisions. As required by the federal Fair Credit Reporting Act (FCRA), the Company provides this clear and conspicuous disclosure, in a document that consists solely of this disclosure, before obtaining any such report.
A consumer report may contain information about your character, general reputation, personal characteristics, and mode of living, including but not limited to information bearing on your work history, education, and criminal record (where permitted). An investigative consumer report is a consumer report in which information is obtained through personal interviews with persons who may have knowledge about you.
The report(s) will be prepared by the following consumer reporting agency (the “CRA”):
The background check may include the following elements, to the extent permitted by applicable federal, state, and local law:
This authorization may be used to obtain reports throughout your employment to the extent permitted by law and consistent with the disclosures provided to you.
Before signing, you should review “A Summary of Your Rights Under the Fair Credit Reporting Act,” a copy of which is being provided to you with this form. You have the right to request additional disclosures about the nature and scope of any investigative consumer report and to receive a written summary of your FCRA rights. If the Company intends to take an adverse action based in whole or in part on a report, you will first receive a copy of the report and the summary of rights, with an opportunity to respond, as required by law.
I have read and understand this Disclosure and the accompanying Summary of Rights. I authorize Galaxy Holdings and its designated CRA, , to obtain consumer reports and investigative consumer reports about me for employment purposes, now and (where lawful) throughout my employment. I authorize all persons, schools, employers, governmental agencies, and other entities to release information about me to the CRA, and I release them and the Company from liability for doing so to the extent permitted by law. A copy or electronic image of this authorization is as valid as the original.
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Name: Michael Yuan
Title: General Manager
Date:
Signature of applicant/employee
Date: