Ps Form 2181-D - Disclosure And Authorization For Consumer Reports And Investigative Consumer Reports

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Disclosure and Authorization for Consumer
Reports and Investigative Consumer Reports
Carefully read the following information before you sign and date this document.
I understand that an agent of the United States Postal Service may obtain a consumer report about me,
investigative consumer report about me, or both, as defined by the Fair Credit Reporting Act. I authorize all
corporations, employers, co-workers, references, credit reporting agencies, educational institutions, licensing
bodies, courts, law enforcement agencies, governmental agencies or departments, and military services to
provide information about my background, including but not limited to driving records, court records, criminal
records, credit reports, academic records, professional license records, and employment information or
records.
I understand that an investigative consumer report is a special type of consumer report obtained through
interviews. The report may contain information about my character, general reputation, personal characteristics,
and mode of living. I may submit a written request within a reasonable period of time to obtain a complete
disclosure of the nature and scope of that investigation. I understand that I will receive a response in writing
within five days of the date the United States Postal Service receives my request.
United States Postal Service Employees or Prospective Employees: I understand that, if I am hired, the United
States Postal Service may also obtain a consumer report, investigative consumer report, or both during
the course of my employment for employment-related purposes. If I am hired, I also authorize the United
States Postal Service to request a consumer report, investigative consumer report, or both about me, for
employment-related purposes, at any time during the course of my employment.
United States Postal Service Contractors and Employees of Contractors: I understand that I may receive this
disclosure even if I am an independent contractor or am employed by an entity with which the Postal Service
contracts for services. The disclosure should not be misconstrued as evidence that I am an employee of the
Postal Service or that the Postal Service believes I am its employee.
I agree that this Disclosure and Authorization will be valid, now or in the future, in original, faxed, copied, or
electronic form.
I acknowledge that I have received a copy of “Summary of Your Rights Under the Fair Credit Reporting Act.”
Signature
Date
Printed Name
2181-D,
PS Form
August 2016

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