BACKGROUND CHECK

Reference Release Authorization

In the interest of maintaining the safety and security of our customers, employees and property, Simply Clean will order a background report on you in connection with your employment application, and if you are hired for employment purposes.

The background report may contain information concerning your character, general reputation, personal characteristics, mode of living, and credit standing. The types of information that may be ordered include but are not limited to: Social Security number verification; criminal, public, educational and, as appropriate, driving records checks; verification of prior employment; reference, licensing and certification checks; credit reports; and drug testing results. The information may be obtained from private and public record sources, including personal interviews with your associates, friends, and neighbors. (An investigative consumer report is a background report that includes information from such personal interviews.) The nature and scope of the most common form of investigative consumer report is an investigation into your education and/or employment history.

I acknowledge that a fax, web form or copy of this release shall be as valid as the original. This release is valid for all federal, state, county and local agencies and authorities.

The following is my complete and legal name, and all information is true and correct to the best of my knowledge.

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