The Leukemia & Lymphoma Society
DISCLOSURE OF EMPLOYER'S INTENTION TO OBTAIN
CONSUMER REPORT FOR EMPLOYMENT PURPOSES
(to be Completed by California Applicants)
The Leukemia & Lymphoma Society ("The Leukemia & Lymphoma Society") may obtain a consumer report on you for employment purposes from LexisNexis Risk & Information Analytics Group, 1000 Alderman Drive, Alpharetta, GA 30005, Telephone: (800) 888-5773. Such report may be obtained in connection with your hiring and/or current employment and additional consumer reports may be obtained in connection with your promotion, reassignment, or retention as an employee. The Leukemia & Lymphoma Society may obtain written, oral, or other communication of information bearing on your character, general reputation, personal characteristics, trustworthiness, creditworthiness, credit standing, credit capacity, or mode of living, from any person or agency which assembles or evaluates individual credit information or other information on individuals for the purposes of furnishing that information to third parties.
The Leukemia & Lymphoma Society may also obtain "investigative consumer reports" that may include some or all of the information listed above obtained from public sources, as well as personal interviews with sources such as your neighbors, friends, fellow employees, or associates. You have a right to request disclosure of the nature and scope of such investigative consumer reports.
Before The Leukemia & Lymphoma Society takes any adverse action based in whole or in part on any information contained in a consumer report, it will provide you with a copy of the report, along with information necessary to contact the consumer reporting agency and a summary of your rights under the Fair Credit Reporting Act.
You should understand that the information collected may relate, but may not necessarily be limited, to:
• Past employment history verification
• Military records
• Education history verification
• Verification of licenses and certifications
• Social security verification
• Your creditworthiness or similar characteristics as set forth in a credit history
• Drug test results
• Any criminal or civil legal records
• All available department of motor vehicles records
• Your behavior while employed by Leukemia & Lymphoma Society
You have a right to obtain a copy of any consumer report or investigative consumer report obtained by The Leukemia & Lymphoma Society by checking the box provided below. The report will be provided to you within three (3) business days after receipt of the requested reports.
Under California law (Civil Code Section 1786.22), you have the right to inspect all files maintained on you by an investigative consumer reporting agency during regular business hours and upon reasonable notice. Files may be inspected in person; copies may be requested in writing (sent certified mail); or a telephone summary of information in files will be provided (upon a written request for telephone disclosure). You may be accompanied by one other person of your choosing. The consumer reporting agency is required to provide trained personnel to explain the contents of your file and to provide a written explanation of any coded information. Proper identification will be required and you will be required to pay the actual costs of duplication services if you request a copy of your file.
At this time, The Leukemia & Lymphoma Society anticipates that any requests for inspection of non-credit reports should be directed to:
LexisNexis Risk & Information Analytics Group
1000 Alderman Drive, Alpharetta, GA 30005
Telephone: (800) 888-5773
Any requests for inspection of credit reports, contact the bureau that supplies the report as listed on the consumer report:
P.O. Box 740241
Atlanta, GA 30374-0241
Telephone: (800) 685-111
Please acknowledge that you have read and understand this Disclosure by checking the box below. Thank you.