Attachment 2(M) - CSO Form 015.pdf

NOTICE AND AUTHORIZATION PERTAINING TO CONSUMER REPORTS

PURSUANT TO THE FAIR CREDIT REPORTING ACT OF 1970, as amended

15 U.S.C. §1681, et seq.

Please take notice that one or more consumer reports may be obtained for employment purposes. Because a background investigation will be conducted as part of a determination of your fitness for employment or for performance under a contract, you are also entitled to request additional disclosures concerning the nature and scope of the investigation.

By signing this form, you are giving consent to have your consumer reports released by consumer reporting agencies as part of an investigation to determine your clearance to perform contractual service and/or security clearance and receive access to Federal and other facilities in accordance with Homeland Security Presidential Directive/HSPD-12. The information obtained may be redisclosed to other Federal agencies for the above purposes and in fulfillment of official responsibilities to the extent that such disclosure is permitted by law.

I ___________________________________________ hereby authorize the U.S. Marshals Service (USMS) to obtain such report(s) from any consumer/credit reporting agency for suitability purposes to perform contractual services.

Signature__________________________________________

Date______________________________________________

Social Security Number_____________________________

Executive Order 9397 (November 22, 1943) asks Federal agencies to use Social Security Numbers (SSN) to help identify individuals in agency records. Your SSN is therefore needed to keep records accurate, because other people may have the same name. Providing your SSN is voluntary.

However, failure to provide the requested information could result in the USMS receiving an erroneous credit report.

INSTRUCTIONS TO THE CONTRACTOR: Please retain a copy of this form for your records and forward the original to the United States Marshals Service, Judicial Security Division, Judicial Protective Services, Attention: Personnel Operations Branch, Washington, DC 20530-1000.

CSO FORM 015 (04/06)

Section J - Attachment 2(P)