Disclosure / Release *

This form, which you should read carefully, has been provided to you because O.E. MEYER CO. may request consumer reports and/or investigative consumer reports on you from a consumer reporting agency. O.E. MEYER CO. will use any such report(s) solely for employment related purposes.

Consumer reports and/or investigative consumer reports on you will be obtained by a background check vendor and provided to O.E. MEYER CO. Any such reports may contain information bearing on your character, general reputation, personal characteristics, mode of living and credit standing. The types of information that may be obtained include, but are not limited to: credit reports, Social Security Number verification, criminal records checks, public court records checks, driving records checks, educational records checks, verification of employment positions held, Workers’ Compensation records (only postoffer), personal and professional references checks, licensing and certification checks, etc. The information contained in these reports may be obtained by the vendor from private and/or public record sources, including sources identified by you on your job application or through interviews or correspondence with your past or present coworkers, neighbors, friends, associates, current or former employers, educational institutions or other acquaintances.

If you are denied employment as a result of information obtained from your background check, O.E. MEYER CO. will furnish you with a summary of your rights under the Fair Credit Reporting Act in a form issued by the Consumer dedicated to supporting each team member in their journey of personal and professional growth throughout their tenure with us.

I have carefully read and understand this Disclosure, Authorization and Release form. By my signature below, I consent to the release of consumer reports and/or investigative consumer reports to O.E. MEYER CO. in conjunction with my job application. I also authorize disclosure to O.E. MEYER CO. and/or to the background check vendor of information concerning my employment history, earning history, education, credit history, credit capacity and credit standing, motor vehicle history and standing, criminal history and all other information O.E. MEYER CO. deems pertinent by any individual, corporation or other private or public entity, including, without limitation, the following: employers; learning institutions, including colleges and universities; law enforcement agencies; federal, state and local courts; the military; credit bureaus; motor vehicle records agencies; and other applicable sources. I hereby release and hold the vendor and O.E. MEYER CO., its officers, directors, employees, agents and trustees harmless from any and all liability with respect to the consumer reports, investigative consumer reports, investigations, verifications and/or the use of any information relevant to my employment.

I understand that if O.E. MEYER CO. hires me, my consent will apply throughout my employment to the extent permitted by law, unless I revoke or cancel my consent by sending a signed letter or statement to O.E. MEYER CO. I also understand that, to the extent allowed by law, information contained in my job application or otherwise disclosed by me before, during or after my employment, if any, may be used for the purpose of obtaining consumer reports and/or investigative consumer reports.

This Background Check Disclosure, Authorization and Release form, in original, faxed, photocopied or electronic form, will be valid for any reports that may be requested by O.E. MEYER CO.

I understand that providing any false information or omitting any material information on my application materials or in the interview process will be sufficient grounds for rejection of the application, or termination of employment whenever discovered.

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, school, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also, that I am required to abide by all rules and regulations of the company.

I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:

• Review information provided by current/previous employers;
• Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and
• Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

Applicant Information

Complete the following requested information.

By entering your name below you confirm that all the information you have provided above is correct.

Education History

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Previous Employment / Experience

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Acknowledgement and Authorization (CDL Drivers Only)

Enter your intial to confirm you have read and agree with the statements below

Experience & Qualifications (CDL Drivers Only)