Global Background Screening Disclosure & Authorization

DISCLOSURE
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*OD (“the Company”) may obtain
In connection with your employment or application for employment, ___________
information about you from a consumer-reporting agency for various “employment purposes” as such term is
defined in The Fair Credit Reporting Act (“FCRA”). Thus, you may be the subject of a “consumer report” or
“investigative consumer report” which may include information about your character, general reputation,
personal characteristics, and/or mode of living, gathered by the consumer reporting agency and reported to the
Company. These reports may contain, but may not be limited to, information regarding your criminal history,
credit history, motor vehicle records (“driving records”), verification of your education or employment history
or other background checks.

[End of Disclosure Statement]

AUTHORIZATION

I have carefully read, and understand, this Authorization document. I understand that if the consumer reports
and/or investigative consumer reports (“Background Reports”) are being provided under the United States Fair
Credit Reporting Act (“FCRA”) By my signature below, I consent to the release of Background Reports prepared
by VITAL4DATA and its designated representatives and agents for the purposes of determining my eligibility for
employment, retention, or other lawful employment purposes. I understand that if the Company hires me,
Company may obtain background reports throughout the term of my employment, if permissible under
applicable law and Company policy. I also understand that nothing herein shall be construed as an offer of
employment.

I understand and authorize the obtainment and release of information for the Background Reports including
but not limited to the following types of information: social security number verifications; address history;
criminal record checks; public court record checks; driving records checks; employment history verifications;
and professional licensing/certification checks. This information may be obtained from private and/or public
records sources, including, as appropriate, governmental agencies and courthouses; educational institutions;
former employers; or other information sources.

I also understand and authorize information contained in my employment application, or otherwise disclosed
by me before, or during, my employment, if any, to be used for the purpose of obtaining Background Reports
I also understand that nothing herein shall be construed as an offer of employment. I hereby authorize law
enforcement agencies, educational institutions (including public and private schools/universities), information
service bureaus, record/data repositories, courts (federal, state, and local), motor vehicle records agencies,
my past or present employers, the military, and other information sources to furnish any, and all, information
on me that is requested by VITAL4DATA its agents or representatives whether within or outside the European
Economic Area (“EEA”) and other countries to release such information.

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 EXHIBIT A
Summary of Your Rights under the Fair Credit Reporting Act
Para información en español, visite www.consumerfinance.gov/learnmore o escribe al Consumer Financial
Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in
the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit
bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical
records, and rental history records). Here is a summary of your major rights under the FCRA. For more
information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write
to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

• You must be told if information in your file has been used against you. Anyone who uses a credit 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 disclosure
will be free. You are entitled to a free file disclosure if:
§ a person has taken adverse action against you because of information in your credit
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. In
addition, all consumers are entitled to one free disclosure every 12 months upon
request from each nationwide credit bureau and from nationwide specialty
consumer reporting agencies. See www.consumerfinance.gov/learnmore for
additional information.

• 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

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 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 www.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, usually 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 agency may not report negative information that is more than seven years old, or bankruptcies
that are more than 10 years old.

• Access to your file is limited. A consumer-reporting agency 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 to employers. A consumer-reporting agency may
not give out information about you to your employer, or a potential employer, without your written
consent given to the employer. Written consent generally is not required in the trucking industry. For
more information, go to www.consumerfinance.gov/learnmore.

• You may limit “prescreened” offers of credit and insurance you get based on information in your credit
report. Unsolicited “prescreened” offers for credit 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. If a 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 victims and active duty military personnel have additional rights. For more information,
visit www.consumerfinance.gov/learnmore. States may enforce the FCRA, and many states have their
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 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 rights, contact:

Retailers, Finance Companies, and All Other FTC Regional Office for region in which the creditor operates
Creditors & Business Types or Federal Trade Commission: Consumer Response Center –
FCRA Washington, DC 20580 (877) 382-4357

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 EXHIBIT B
State Law Notices:

California, Minnesota or Oklahoma applicants only:

You may receive a free copy of any consumer report or investigative consumer report obtained
on you if you check the box below.

r I wish to receive a free copy of the report. 7

Additional State Law Notices

California, Oklahoma and Minnesota: You have the right to receive a copy of your background/investigative
report by checking the box on the Authorization of Background Investigation below. California Law: Pursuant
to Section 1786.22 of the California Civil Code, you may view the file maintained on you by VITAL4DATA during
normal business hours. You may also obtain a copy of this file, upon submitting proper identification by
appearing at VITAL4DATA’s offices in person, during normal business hours and on reasonable notice, or by mail.
You may also receive a summary of the file by telephone, upon submitting proper identification. VITAL4DATA
has trained personnel available to explain your file to you, including any coded information.

Maine: You have the right, upon request, to be informed of whether an investigative background report was
requested, and if one was requested, the name, address, and telephone number of the nearest unit designated
to handle inquiries of each background-reporting agency issuing an investigative consumer report. You also have
the right, under Maine law, to request and promptly receive from all such agencies copies of any such reports.

Massachusetts and New Jersey: If we request an investigative background report, you have the right, upon
written request, to a copy of the report.

New York Applicants Only: I acknowledge receipt of a copy of Article 23-A of New York Correction Law.
By signing the Authorization below, I certify that I have read and fully understand this release, that prior to
signing I was given an opportunity to ask questions and to have those questions answered to my satisfaction,
and that I executed this release voluntarily and with the knowledge that the information being released could
affect my being hired, my employment, or my eligibility for promotion.

Washington State: If Company requests an investigative background report, you have the right, upon written
request made within a reasonable period of time after your receipt of this disclosure, to receive from Company
a complete and accurate disclosure of the nature and scope of the investigation requested by Company. You
also have the right to request from the consumer-reporting agency a written summary of your rights and
remedies under the Washington Fair Credit Reporting Act.

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