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T-R Information Services P.O. Box 780254 Orlando, FL 32878
Phone: 800-894-9141 Fax: 407-306-0277
Date
Social Security Number: Date of Birth: Drivers License Number
In connection with any application made by me, (Employment or Tenant) I understand that investigative background inquiries may be made on me concerning matters of consumer credit, criminal convictions, motor vehicle information and/or other reports. These reports can include information as to my character, work habits, performance, education and experience along with reasons for termination of employment from previous employers, if any. I understand that you may be requesting inform- ation from various Federal, State, and other agencies which maintain records concerning past activities relating to my credit, criminal, driving, civil and other records and experiences, including claims involving me, in the files of insurance companies, if any. I authorize, without reservation, any party or agency contacted to furnish the above mentioned information and release all parties involved from any liability and/or responsibility for doing so. I hereby consent to any potential employer's obtaining the such information from T-R Information Services and/or any of their agents. This authorization and consent shall valid in an original, fax or copy form.
I have the right to make a request to TR Information Services, upon proper identification and the payment of any authorized fees, the information in its files on me at any time of my request.
T-R Information Services does herby agree to provide the requested information in accordance the Fair Credit Reporting Act and submit a written report via U.S. mail or fax.
Signature: X___________________________________________