Legal BI Release Form

LEGAL BI RELEASE FORM

This Legal BI Release Form (the Agreement) is entered into on this date: by and between Requesting Entity: (Requesting Party) and Individual: (Individual). The Requesting Party and Individual are collectively referred to as the Parties.

RECITALS

WHEREAS, the Requesting Party requires certain background, identity and related information respecting the Individual in connection with the Individual's consideration for employment, engagement, or contractual relationship with the Requesting Party;

WHEREAS, the Individual is willing to provide authorization for the collection, use and disclosure of such information to permit the Requesting Party to evaluate suitability; and

WHEREAS, the Parties desire to set forth their respective understandings and the scope of consent and release regarding the collection and use of background information.

NOW, THEREFORE, in consideration of the mutual covenants contained herein and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the Parties agree as follows:

1. AUTHORIZATION AND RELEASE

The Individual hereby authorizes the Requesting Party, its agents, affiliates, representatives, and any third-party consumer reporting agencies or investigators retained by the Requesting Party (collectively, Authorized Agents), to obtain, receive and review background information concerning the Individual. Such information may include, but is not limited to, consumer reports, investigative consumer reports, criminal records, driving records, education and employment history, professional licenses, credit history where expressly permitted by applicable law, military records, and any other verifiable records reasonably related to the purpose described in Section 2 below. The Individual releases and discharges the Requesting Party and its Authorized Agents from all liability arising from the collection, use and disclosure of such information to the extent permitted by law.

2. PURPOSE AND SCOPE

The background information authorized by this Agreement shall be obtained solely for the purpose of evaluating the Individual's suitability for employment, engagement, or continued association with the Requesting Party. The scope of permissible inquiries includes verification of identity, employment history, educational credentials, professional licensing, criminal history, civil litigation and other public records, driving records and other information reasonably related to the Individual's fitness for the position or relationship.

3. TYPES OF INFORMATION AUTHORIZED

The Individual expressly authorizes collection of the following categories of information (check all that apply):

4. CONSUMER REPORTS AND INVESTIGATIVE CONSUMER REPORTS

To the extent any information obtained constitutes a consumer report or investigative consumer report under applicable law, the Individual is notified that such reports may be obtained and the Individual has the right to request disclosure of the nature and scope of any investigative consumer report requested. The Individual understands that, where required by law, a conditional adverse action will not be taken based on such a report without first providing the Individual a copy of the report and a written description of the Individual's rights under the relevant consumer reporting statutes.

5. AUTHORIZED DISCLOSURE AND USE

The Individual consents to the disclosure of obtained information to the Requesting Party and to those employees, agents or representatives of the Requesting Party with a legitimate need to know for the purpose set forth in Section 2. The Requesting Party shall use and disclose such information only for employment, contracting, safety, regulatory, or other legitimate business purposes consistent with this Agreement and applicable law.

6. REPRESENTATIONS AND WARRANTIES

The Individual represents that the information provided to facilitate the background check is true and correct to the best of the Individual's knowledge. The Requesting Party represents that it will comply with all statutory requirements applicable to the procurement, use and disposal of consumer information, including any required disclosures and adverse action procedures.

7. LIMITATION OF LIABILITY AND INDEMNIFICATION

To the fullest extent permitted by law, the Requesting Party and its Authorized Agents shall not be liable to the Individual for any inaccuracy in records from third-party sources. The Individual agrees to indemnify, defend, and hold harmless the Requesting Party and its Authorized Agents from any claims, liabilities or damages arising from false or misleading information knowingly provided by the Individual or from claims arising out of the authorized disclosure and use of background information in accordance with this Agreement.

8. CONFIDENTIALITY AND RETENTION

The Requesting Party shall keep all background information received under this Agreement confidential and shall retain such information only for so long as required by applicable law or by its legitimate business needs. Copies of reports provided to the Requesting Party shall be maintained in a secure manner and access limited to authorized personnel.

9. NOTICES

Any notice required or permitted under this Agreement shall be in writing and delivered to the addresses provided below. Notices shall be effective upon personal delivery or three (3) business days after deposit in the mail, postage prepaid.

10. AMENDMENT, WAIVER, COUNTERPARTS

This Agreement may be amended only by a written instrument executed by both Parties. No waiver of any provision or breach shall be effective unless in writing and signed by the party granting such waiver. This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

11. GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the state or jurisdiction specified by the Requesting Party in its regular place of business, without giving effect to conflict of law principles that would result in the application of the laws of another jurisdiction.

12. ENTIRE AGREEMENT

This Agreement constitutes the entire agreement between the Parties concerning the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings, whether written or oral, relating to the subject matter herein.

13. SEVERABILITY

If any provision of this Agreement is held to be invalid, illegal or unenforceable in any respect by a tribunal of competent jurisdiction, the remaining provisions shall remain in full force and effect and shall be construed so as to effectuate the original intent of the Parties to the fullest extent permitted by law.

14. ADDITIONAL INDIVIDUAL INFORMATION

To assist in accurate identification, the Individual provides the following information as applicable.

15. ACKNOWLEDGMENT AND CONSENT

By signing below, the Individual acknowledges receipt of a copy of this Authorization and Release, confirms that the Individual has read and understands its contents, and provides voluntary, informed consent to the procurement and disclosure of the information described herein for the stated purposes. The Individual understands that this Authorization shall remain in effect for a period of one year from the date below unless revoked in writing earlier, provided that any revocation will not affect actions taken prior to receipt of such revocation.

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