Background Check Release

  • Omaha Track Background Check Release

    The following form will allow you to provide the necessary information for Omaha Track to perform a background check as well as allow you to provide your consent for such a background check.
  • Disclosure of background check to be conducted on you

    In connection with your application and/or employment/membership/volunteer duty with Omaha Track, Inc (“Employer”) this notice is provided to inform you that a “consumer report” and/or “investigative consumer report”, as defined by the Fair Credit Reporting Act, may be obtained from a consumer reporting agency for employment purposes. These types of reports may include information as to your character, general reputation, personal characteristics and mode of living, whichever are applicable. The report(s) may also contain information about you relating to your criminal history, credit history, driving and/or motor vehicle records, verification of your education or employment history and other background checks. They may involve interviews with sources such as your neighbors, friends or associates.
  • Summary of Your Rights Under the Fair Credit Reporting Act

    Para informacion en espanol, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

    The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

    You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment - or to take another adverse action against you - must tell you, and must give you the name, address, and phone number of the agency that provided the information.

    You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your "file disclosure"). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:

    • a person has taken adverse action against you because of information in your credit report;

    • you are the victim of identify theft and place a fraud alert in your file;

    • your file contains inaccurate information as a result of fraud;

    • you are on public assistance;

    • you are unemployed but expect to apply for employment within 60 days.

    In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.

    You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.

    You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.

    Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.

    Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.

    Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need - usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.

    You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.

    You may limit "prescreened" offers of credit and insurance you get based on information in your credit report. Unsolicited "prescreened" offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from thelists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-567-8688.

    You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.

    Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. For information about your federal rights, contact:

    1.a. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates. Bureau of Consumer Financial Protection 1700 G Street NW Washington, DC 20552

    1.b. Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the CFPB:

    Federal Trade Commission: Consumer Response Center - FCRA Washington, DC 20580 (877) 382-4357

    2. To the extent not included in item 1 above :a. National banks, federal savings associations, and federal branches and federal agencies of foreign banks

    Office of the Comptroller of the Currency Customer Assistance Group 1301 McKinney Street, Suite 3450 Houston, TX 77010-9050

    2.b. State member banks, branches and agencies of foreign banks (other than federal branches, federal agencies, and insured state branches of foreign banks), commercial lending companies owned or controlled by foreign banks, and organizations operating under section 25 or 25A of the Federal Reserve Act

    Federal Reserve Consumer Help Center P.O. Box 1200 Minneapolis, MN 55480

    2.c. Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associations

    FDIC Consumer Response Center 1100 Walnut Street, Box #11 Kansas City, MO 64106

    2.d. Federal Credit Unions

    National Credit Union Administration Office of Consumer Protection (OCP) Division of Consumer Compliance and Outreach (DCCO) 1775 Duke Street Alexandria, VA 22314

    3. Air carriers

    Asst. General Counsel for Aviation Enforcement & Proceedings Aviation Consumer Protection Division Department of Transportation 1200 New Jersey Ave, S.E. Washington, DC 20590

    4. Creditors Subject to Surface Transportation Board

    Office of Proceedings, Surface Transportation Board Department of Transportation 1925 K Street NW Washington, DC 20423

    5. Creditors Subject to Packers and Stockyards Act

    Nearest Packers and Stockyards Administration area supervisor

    6. Small Business Investment Companies

    Associate Deputy Administrator for Capital Access United States Small Business Administration 406 Third Street, SW, 8th Floor Washington, DC 20416

    7. Brokers and Dealers

    Securities and Exchange Commission 100 F St NE Washington, DC 20549

    8. Federal Land Banks, Federal Land Bank Associations, Federal

    Intermediate Credit Banks, and Production Credit Associations Farm Credit Administration 1501 Farm Credit Drive McLean, VA 22102-5090

    9. Retailers, Finance Companies, and All Other Creditors Not Listed Above

    FTC Regional Office for region in which the creditor operates or Federal Trade Commission: Consumer Response Center - FCRA Washington, DC 20580 (877) 382-4357

  • State Required Notices

    Minnesota applicants or employees only: You have the right, upon written request to Crimcheck.com, to receive a complete and accurate disclosure of the nature and scope of any consumer report. Crimcheck.com, Inc. must make this disclosure within five days of receipt of your request or of Employer’s request for the report, whichever is later. Please check the box below if you would like to receive a copy of a consumer report if one is obtained by Employer.

    Massachusetts and New Jersey applicants or employees only: You have the right to inspect and promptly receive a copy of any investigative consumer report requested by Employer by contacting the consumer reporting agency, Crimcheck.com, Inc., directly.

    Oklahoma applicants or employees only: Please check the box below if you would like to receive a copy of a consumer report if one is obtained by Employer.

    New York applicants or employees only: You have the right, upon request, to be informed of whether or not a consumer report was requested from a consumer reporting agency by contacting the consumer reporting agency, Crimcheck. If a consumer report is requested, you will again be provided with the name and address of the consumer reporting agency furnishing the report. You may inspect and receive a copy of the report by contacting Crimcheck. By continuing, you acknowledge receipt of Article 23-A of the New York Correction Law.

    Washington State applicants or employees only: You have the right to receive a complete and accurate disclosure of the nature and scope of any investigative consumer report as well as a written summary of your rights and remedies under Washington law.

    California applicants or employees only: By continuing, you acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION PURSUANT TO CALIFORNIA LAW, available by clicking HERE. Please check the box below if you would like to receive a copy of an investigative consumer report at no charge if one is obtained by the Company whenever you have a right to receive such a copy under California law.

    Crimcheck.com 17295 Foltz Industrial Parkway Suite B Strongsville, OH 44149 Toll Free 1-877-992-4325 http://www.crimcheck.com

  • Acknowledgment and Authorization of Background Check

    By signing below, I authorize Omaha Track, Inc (“Employer”) to obtain “consumer reports” and/or “investigative consumer reports” during the application process or during the course of employment/membership/volunteer duty, to the extent permitted by law.

    You have the right, upon written request made within a reasonable amount time after the receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report by contacting Crimcheck.com 17295 Foltz Industrial Parkway, Suite B, Strongsville, OH 44149 [1-877-992-4325].

  • Clear Signature
  • Self Admitted Crimes

    If you have ever been convicted of a crime other than a minor traffic offense please list below (if applicable). At least one location indicator is required (city, county, state or zip code) and the crime description.
  • This field is for validation purposes and should be left unchanged.