Company Letterhead
{{company_name}}
{{company_address}}
Phone: {{company_phone}}
Email: {{company_email}}
Website: {{company_website}}
Date
{{date}}
Purpose of Report
I understand that the Company intends to use the information obtained from this credit report for employment purposes, specifically for evaluating my application for employment/continued employment in the position of {{position_title}}. I acknowledge that the information obtained will be used in a confidential manner and in compliance with all applicable laws and regulations regarding consumer credit reports.
Waiver and Release
I hereby release and forever discharge {{company_name}}, its officers, directors, employees, and agents from any and all claims, demands, liabilities, damages, and causes of action of any kind or nature whatsoever, whether known or unknown, arising from or relating to the procurement, use, or disclosure of my credit report. I understand that this release includes, but is not limited to, claims for defamation, invasion of privacy, negligence, and any action under the National Credit Act (or equivalent national legislation).
I further waive any right I may have to review or receive a copy of any reports or other information obtained by the Company pursuant to this authorization, except as may be required by law.
Confidentiality
I understand that any information obtained as a result of this credit report will be treated as confidential and will only be used for the stated employment purposes. The Company will take all reasonable steps to ensure the security and privacy of my personal information in accordance with applicable data protection laws.
Governing Law
This Authorization, Waiver, and Release shall be governed by and construed in accordance with the laws of {{country_name}}.
Declaration and Consent
I declare that the information provided in this form is true and accurate to the best of my knowledge and belief. I have read and understood the terms and conditions outlined in this document and voluntarily give my consent for the Company to obtain and use my credit report for the purposes stated herein.
Signature Block
___________________________
{{employee_name}}
Date: _______________
___________________________
{{company_representative_name}}
{{company_representative_title}}
For and on behalf of {{company_name}}
Date: _______________
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