CONSENT
TO OBTAIN INFORMATION
In connection with my application for the truck
lease purchase program, I understand that a consumer report,
which may contain public record information, is being requested
from DAC Services Tulsa, OK. This report may include the following
types of information: Names and dates of previous employers,
reason for termination of employment, work experience, at fault
and not at fault accidents, etc. I further understand that
such reports may contain public record information concerning
my driving record, workers’ compensation claims, credit,
bankruptcy proceedings, criminal records, etc., from Federal,
State, and other reporting agencies; as well as information
from DAC concerning; (1) previous driving record requests made
by others, from such State agencies, (2) State provided driving
record, (3) claims involving me (named below) in the files
of insurance companies.
I AUTHORIZE WITHOUT RESERVATION, ANY PARTY,
OR AGENCY CONTACTED BY DAC SERVICES, TO FURNISH THE ABOVE-MENTIONED
INFORMATION.
I have the right to contact DAC, upon proper
identification, to request the nature and substance of all
information in their file, on me, at the time of my request,
including the sources of information, and the names of any
recipients requesting reports on me, from DAC, within a two
(2) year period preceding my request. I do hereby consent
to your obtaining the above-mentioned information from DAC
Services and the Chosen Approved Carrier named above. I agree
that such information obtained can be used in the determination
of eligibility for the truck lease purchase program. My participation
in the truck lease purchase program may be supplied by DAC
to other subscribers to DAC Services. |
