Panum Group LLC Disclosure and Authorization Pertaining to Consumer Reports

Panum Group, LLC Disclosure and Authorization Pertaining to Consumer Reports (Pursuant to the Fair Credit Reporting Act) and Background Check This is a release for the Panum Group, LLC (Panum) to obtain (1) one or more consumer/credit reports and (2) Background Data about you in connection with your application for employment or in the course of your employment with Panum. One or more reports about you may be obtained for employment purposes, including evaluating your fitness for employment, promotion, reassignment, retention, or access to classified information. I, hereby authorize Panum Group, LLC to obtain such report(s) from any consumer/credit reporting agency and law agency(s) for employment purposes. Signature: _______________________________ Print Name_______________________________ Date__________________________ SSN__________________________

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