Authorization to Obtain Consumer Reports and/or Driving Records

Job Applicant/Employee(*)
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Street Address(*)
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City, State, Zip(*)
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Date of Birth(*)
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Drivers License #(*)
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State License(*)
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Prospective Employer/Current Employer(*)
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Consumer Reports may be obtained as part of the (Prospective Employer/Employer) evaluation of my job applications/employment. The reports may be procured by by Oakland Insurance Agency and may include my driving record, an assessment of my insurability under the Company's insurance coverage's, or other consumer reports. By signing this discloser, I hereby authorize the Company to procure such reports and additional reports about me from time to time, as it deems appropriate, to evaluate my insurability or for other permissible purposes.
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(Signature of Job Applicant/Employee)

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(Typed or Printed Name of Job Applicant/Employee)

Date(*)
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