Barnes & Noble College Bookstores Inc Job Application Form (Page 3 of 3) in pdf

CONSUMER REPORT AND INVESTIGATIVE CONSUMER REPORT

DISCLOSURE AND AUTHORIZATION

I am seeking employment with Barnes & Noble College Booksellers (“Barnes & Noble”). In

connection with my application for employment Barnes & Noble has notified me that a

"consumer report" and/or an "investigative consumer report" may be obtained for

"employment purposes" as part of the preemployment background investigation and/or at any

time during my employment, pursuant to and in accordance with the Fair Credit Reporting

Act (the “FCRA”) (terms in quotations and not otherwise defined are defined in the FCRA). I

understand that I may request that Barnes & Noble make a complete disclosure of the nature

and scope of the investigation, if any, that was requested, and that Barnes & Noble has

provided me with a summary of my rights under the FCRA. (Under the FCRA, “employment

purposes” means for the purpose of evaluating a consumer for employment, promotion,

reassignment or retention as an employee.)

I authorize Barnes & Noble to procure a consumer report and/or an investigative

consumer report as part of the preemployment background investigation. If hired, this

authorization shall remain in effect and shall serve as an ongoing authorization for Barnes &

Noble to procure consumer reports and/or investigative consumer reports at any time during

my employment. I expressly acknowledge that such reports will contain information about

me, including without limitation, information about my character, general reputation,

personal characteristics, or mode of living, that is obtained from personal interviews with my

neighbors, friends and associates.

I authorize all entities (such as, former employers, credit agencies, educational

institutions, law enforcement agencies, city, state, county and federal courts, military services

and personnel departments or agencies) and persons (including without limitation, my

neighbors, friends, associates or others with whom I am acquainted), who may have

knowledge concerning me, my character, general reputation, personal characteristics, or

mode of living, to release information they may have about me to Barnes & Noble or to

Barnes & Noble’s authorized agents, and I release Barnes & Noble and all parties involved

from any and all liability for damages arising from requesting, procuring or furnishing the

requested information, except with respect to any violation of the FCRA or otherwise

prohibited by law.

This authorization, in original or copy form, shall be valid for any current and any

future reports or updates that may be requested. I understand that the consumer reports or

investigative consumer reports requested by Barnes & Noble will be used only for the

permissible purposes outlined in the FCRA and will not be used for any purpose prohibited

by any applicable federal or state law.

I HAVE READ AND I UNDERSTAND ALL OF THE ABOVE, I ACKNOWLEDGE

RECEIPT OF THIS DISCLOSURE, AND I HEREBY GRANT THE

AUTHORIZATION DESCRIBED HEREIN

Print Name: ______________________ Sign Name:____________________________

Date:__________ SS#:___________ Other Names Used: _______________________

Barnes & Noble College Bookstores Inc Job Application Form Page 3