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RELEASE FOR PROCUREMENT
of CREDIT REPORT

I understand that my credit report and files may be obtained during the course of a background investigation.

I authorize the procurement of a credit report. ______ (initial here)

___________________________________________
Your Signature

I understand that if I am denied employment based upon the information provided in my credit file, upon request, a copy of my Credit Report, and a copy of my rights under the Fair Credit Reporting Act will be provided.

___________________________________________
Your Signature

____________________________________________
Your Full Name, typed or printed

____________________________________________
Your Address

____________________________________________
Your Address

 _______/_____/________
  Social Security Number

THANK YOU

Click HERE to view the text
of the Fair Credit Reporting Act

Click HERE for a printer friendly version of this form.

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FOR INFORMATION FROM IBRInc
PLEASE CONTACT:

IBRInc
Post Office Box 817
New Port Richey, Florida  34656-0817
Telephone: (727) 944-5888
Toll-Free: (800) 994-1100
Fax: (727) 944-5828
e-mail: sales@ibrinc.com
License #A9600263

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If you have questions or comments about this web site
please e-mail: webmaster@ibrinc.com

Last Modified 01/29/2000    ibrinc.com