Volunteer General Release Form printable pdf download

Revised 2/2010

VOLUNTEER GENERAL RELEASE FORM

[IMPORTANT – PLEASE TYPE OR PRINT CLEARLY]

ORGANIZATION - Company Name: ______________________________________________

Address: __________________________________________________________________

City: _______________________________ State: _________ Zip Code: _____________

*************************************************************************

Subject - First Name: ____________________ MI: ______ Last: ______________________

Maiden or Alias Names Used: _________________________________________________

Social Security Number: _______________________________ DOB: _________________

Driver License Number: _______________________________ State: ________________

Current Street Address: ______________________________________________________

City: _______________________________ State: _________ Zip Code: _____________

NOTICE AND ACKNOWLEDGMENT

[IMPORTANT – PLEASE READ CAREFULLY BEFORE SIGNING]

NOTICE REGARDING BACKGROUND INVESTIGATION

Organization may obtain information about you from a consumer reporting agency for volunteer purposes. Thus, you may be the

subject of a “consumer report” and/or an “investigative consumer report” which may include information about your character,

general reputation, personal characteristics, and/or mode of living, and which can involve personal interviews with sources such as

your neighbors, friends, or associates. These reports may be obtained at any time after receipt of your authorization and, if you are

accepted to volunteer, throughout your volunteer period. You have the right, upon written request made within a reasonable time

after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report. Please be advised

that the nature and scope of the most common form of investigative consumer report obtained with regard to applicants for

employment is an investigation into your education and/or employment history conducted by Clear Investigative Advantage LLC,

3000 Internet Blvd., Suite 610, Frisco TX 75034, Tel: 888-242-2503 or another outside organization. The scope of this notice

and authorization is all-encompassing, however, allowing Organization to obtain from any outside organization all manner of

consumer reports and investigative consumer reports now and, if you are accepted to volunteer, throughout the course of your

volunteer period to the extent permitted by law. As a result, you should carefully consider whether to exercise your right to request

disclosure of the nature and scope of any investigative consumer report.

New York applicants or employees only: You have the right to inspect and receive a copy of any investigative consumer report

requested by Organization by contacting the consumer reporting agency identified above directly.

ACKNOWLEDGMENT AND AUTHORIZATION

I acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION and A SUMMARY OF YOUR RIGHTS UNDER THE

FAIR CREDIT REPORTING ACT and certify that I have read and understand both of those documents.

I hereby authorize the

obtaining of “consumer reports” and/or “investigative consumer reports” at any time after receipt of this authorization and, if I am

accepted to volunteer, throughout my volunteer period. To this end, I hereby authorize, without reservation, any law enforcement

agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau,

employer, or insurance company to furnish any and all background information requested by Clear Investigative Advantage or

another outside organization acting on behalf of Organization, and/or Organization itself.

I agree that a facsimile (“fax”) or

photographic copy of this Authorization shall be as valid as the original.

Minnesota and Oklahoma applicants or employees only: Please check this box if you would like to receive a copy of a consumer

report if one is obtained by the Company.

California applicants or employees only: By signing below, you also acknowledge receipt of the NOTICE REGARDING BACKGROUND

INVESTIGATION PURSUANT TO CALIFORNIA LAW.

Please check this box if you would like to receive a copy of an investigative

consumer report or consumer credit report if one is obtained by Organization at no charge whenever you have a right to receive such

a copy under California law.

Signature: _________________________________ Date: ____________________

Clear Investigative Advantage, LLC

Volunteer General Release Form

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