Typing and Analyzing Files for

Thank you for your interest in typing and analyzing files for !

Who we are

transcribes voicemail messages, memos, letters, legal files, medical files, recordings of phone calls, conference calls and other audio files.

also audits, summarizes, evaluates and analyzes audio recordings and phone conversations.

Some audio files, like voicemail messages, may average just 2-3 minutes in length, while other recordings may be significantly longer, perhaps as long as an hour or two.

What we require of our contractors

1. Accurate spelling and punctuation.

2. Individuals that know how to follow instructions.

3. Typists that can listen to voice files and accurately type what they hear.

4. Experienced and professional transcriptionists.

5. Typists with their own equipment, supplies, facilities (office/ work space).

6. Honesty, integrity and reliability.

7. No convictions of a felony or misdemeanor on your record. (Do not proceed if you have any conviction on your record.)

8. Take a typing quiz for for each language or speciality you are interested in (examples: English, Spanish, French, Medical, etc.). You may also be given an opportunity to be tested to analyze audio files.

9. Take a test to ensure you understand 's requirements.

10. You will stay in touch with Brand-x Call Center with the recommended Instant Messenger service.

How to get started to determine if you qualify to receive typing and/or analyst assignments

The following must be done in order.

1. Review and follow all procedures and requirements.

2. Review and follow all procedures and requirements outlined in the HIPAA Business Associate Agreement (below).

3. Fill out the form below and tell us a little bit about yourself. This will create a typist account in our system, which will be activated if your references check out, you pass your tests and quizzes, and we decide to offer you typing assignments. Make sure you write down your typist account username and password during signup.

4. When you create your typist account, you are agreeing to abide by our strict confidentiality requirements and code of ethics (outlined below). You will also be providing us with references. You should use NON-family members as your references.

When you click "I Agree" on our Sign up form, you are also agreeing to the following:

I acknowledge that I am offering my services as an independent contractor to ("Company").

I acknowledge that I decide when, how much, or how little I work, and that I set my own hours.

I acknowledge that I unilaterally decide where to do my typing, whether that is in my office, my home, or anywhere else.

I have invested capital to purchase or rent my office or home office, office facilities, equipment and supplies.

I hire and direct and have the right to hire and direct my own assistants and staff, and I am responsible for paying them. Anyone working for me is not an agent or representative of Company. Further, I am responsible for supervising my assistants.

I am personally responsible for maintaining my own office, computer(s) and other equipment such as, but not limited to speakers, headsets, software, hardware, monitors, foot pedals etc.

I am responsible for my own continuing and recurring liabilities or obligations for my work facilities (rent, mortgage payment, utilities, computer repairs, etc.)

My ability to make a profit, or risk of suffering a loss is based on the relationship between my income and my expenses. I understand that if the customer speaks slowly, necessitating that I spend extra time transcribing, I run the risk of losing money especially if I am paying my assistant(s) by the hour.

I agree to deliver the transcription to Company at the pricing agreed to in advance.

I understand that I have the right to provide my transcription services to other companies or clients at any time.

I acknowledge that I offer my transcription service to the general public and have the necessary business license for my transcription business.

I agree that if and when I accept any assignment from Company, I am responsible and obligated to complete it. Further, I have the skills to accept and complete assignments and do not need to be trained.

Once I accept and complete an assignment, I understand and agree that I do not have the right to be offered, or the obligation to accept future assignments. If company would like to offer me an additional assignment, this may be done by e-mail or Yahoo messenger.

If and when I am offered an assignment, I am free to accept or reject it. If I accept it, I acknowledge that Company cannot tell me how to do the work.

Each file that I am offered is considered one assignment.

I acknowledge that company cannot control or direct the order or sequence that I do my work.

Confidentiality

The audios you hear and the material you type is absolutely confidential and NO INFORMATION is to be discussed or shared with anyone, including family members.

Note that by creating your typist account you are agreeing to all of our confidentiality requirements.

Also, using or referencing any customer, if known, in a blog or any other public or private forum is prohibited.

Legal action will be taken against violators.

Click here to read the agreements Typist Handbook, Company Policies and Code of Ethics Typist Handbook, Company Policies and Code of Ethics I. INTRODUCTION This handbook ensures compliance with legal requirements and our set standards of business conduct. All typists are considered independent contractors who are expected to read and comprehend this handbook and comply with these guidelines. Contractors who violate the law or this Code of Business Conduct and Ethics will not be offered assignments. - Honesty, integrity and ethics are the critical to your contracting with . II. COMPANY POLICIES AND CODE OF ETHICS General: - No contractor shall distribute or circulate any unauthorized, electronic, written or printed material to anyone at any time. - The Company and its client's Confidential Information is a valuable asset. Confidential information includes product architectures; source codes; product plans and road maps; names and lists of customers, customer's audio/video files and transcripts and/or other relevant information. This information is the property of the Company and its clients and must be protected and safeguarded, whether by patent, trademark, copyright, trade secret or any other laws. All confidential information must be used for Company business purposes only and must be safeguarded. - NDA: As you sign an agreement to protect and hold confidential the Company's or its clients' proprietary information, this agreement remains in effect during and after you accept assignments from the Company. Under this agreement, you may not disclose the Company and/or its clients' confidential information to anyone or use it to benefit anyone other than the Company without the prior written consent of an authorized Company officer. - No Confidential Information is to remain on off-premise computers. Files and data are maintained on Company servers and may only be viewed via your login and password. - Posting or discussing information concerning the Company's services or business on the Internet is prohibited. - Unacceptable uses of remote (non-Company) computer facilities include but are not limited to: o Intentional damage of Company data, o Disabling or corrupting software o Transmission of any company or client information without prior authorization Quality - Quality of transcripts will be audited randomly. Customers will be asked to rate typists' performance. Communication - Communication regarding your assignments is essential. Contractors are responsible for communicating with the Company.

Confidentiality Agreement Confidentiality Agreement 1. represents that it owns or controls certain voice files, written files and other information relating to its business and to its customers- affairs, which is proprietary and confidential. 2. The parties are desirous of entering into negotiations with or doing business with each other, but desires to protect its practices, methodology, customer lists, customer data, customer's leases, concession agreements, contracts, records, software, accounting and financial data and all other confidential information which may come into your knowledge or possession (hereinafter referred to as Confidential Information). 3. Purpose Clause: is willing to disclose the Confidential Information to you, or allow you access to such Confidential information in the course of your employment or relationship with . 4. agrees to disclose Confidential Information to you on the following terms and conditions: - You agree not to disclose any Confidential Information to any third party, or use any such Confidential Information other than for the purposes set forth in the Purpose Clause above, except with the express written consent of . - Notwithstanding the foregoing, you may disclose Confidential Information pursuant to the requirement of a Governmental Agency, by operation of law or pursuant to court order. 5. The following information shall not be deemed Confidential Information and you shall have no obligation with respect to information which: - is in the public domain at the time of disclosure or later enters the public domain without your involvement or actions, or - is received from a third party without your involvement, or - is presently known by you or is acquired or developed independent by of the disclosures made pursuant to this Agreement. 6. The Confidential Information shall at all times remain the property of . At any time at 's option or promptly upon 's request, you shall return to any written or otherwise recorded Confidential Information that may be in your posession, and no portion of such Confidential Information shall be retained in any form by you. 7. You shall not say anything negative about or any of its customers or clients in public or private and shall not request any customer to cancel its business with . You shall not divert or try to divert any customer to another similar company or help any other similar company obtain any business from any customer without the written consent of .

HIPAA Business Associate Agreement. BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (the "Agreement") is made and entered into this _____ day of ________________, _____, by and between ("Business Associate") and ___________________________________________ ("Covered Entity"). WHEREAS, Title II of the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") requires that Covered Entity and Business Associate enter into an Agreement complying with certain requirements of HIPAA, as described at 45 CFR § 164.504; and WHEREAS, Covered Entity and Business Associate desire to ensure complete compliance with HIPAA as described in this Business Associate Agreement. NOW THEREFORE, Covered Entity and Business Associate enter into the following Business Associate Agreement. I. DEFINITIONS a. Specific definitions. (i) Data Aggregation. With respect to PHI created or received by Business Associate in its capacity as a Business Associate of Covered Entity, the term "Data Aggregation" means the combining of such PHI by Business Associate with PHI received by Business Associate in its capacity as business associate of another entity to permit data analyses that relate to the health care operations of the respective entities. (ii) Designated Record Set. The term "Designated Record Set" means a group of records maintained by or for the Covered Entity that is: (A) The enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan; or (B) Used by or for the Covered Entity to make decisions about Individuals. For purposes of this paragraph, the term .record. means any item, collection, or grouping of information that includes PHI and is maintained, collected, used, or disclosed by or for the Covered Entity. (iii) Individual. The term "Individual" shall have the same meaning as the term "individual" in 45 CFR §160.103, and shall include a person who qualifies as a personal representative in accordance with 45 CFR §164.502(g). (iv) Privacy Rule. The term "Privacy Rule" shall mean the Standards for Privacy of Individually Identifiable Health Information at 45 CFR Part 160 and Part 164, Subparts A and E, as from time to time amended. (v) Protected Health Information. The term "Protected Health Information" ("PHI") shall mean individually identifiable health information maintained and transmitted in any form or medium, including, without limitation, all information (including demographic, medical, and financial information), data, documentation, and materials which are created or received by a healt h care provider, school, health plan, employer, or health care clearinghouse, and relate to: (A) the past, present, or future physical or mental health or condition of an Individual; (B) the provision of health care to an Individual; or (C) the past, present, or future payment for the provision of health care to an Individual, and that identifies or could reasonably be used to identify an Individual. PHI does not include: (1) health information that has been de-identified in accordance with the standards for de-identification contained in the Privacy Rule, or (2) employment records. (vi) Required By Law. The term "Required By Law" shall have the same meaning as "required by law" in 45 CFR §164.103. (vii) Secretary. The term "Secretary" shall mean the Secretary of the Department of Health and Human Services ("HHS") or his or her designee. II. OBLIGATIONS AND ACTIVITIES OF BUSINESS ASSOCIATE a. Business Associate acknowledges that in providing services to Covered Entity, it will create, receive, use or disclose PHI. b. Business Associate agrees that it will not use or disclose PHI except as permitted or required by this Agreement, or as Required By Law. c. Business Associate agrees that it will use appropriate safeguards to prevent use or disclosure of PHI other than as provided in this Agreement. d. Business Associate agrees to mitigate, to the extent practicable, any harmful effects known to it which are caused by a use or disclosure of PHI by it or by one of its agents or subcontractors in violation of the requirements of this Agreemen t. e. Business Associate agrees that it will report to Covered Entity any use or disclosure of PHI not allowed by this Agreement if it becomes aware of the use or disclosure. f. Business Associate agrees that it will ensure that any agent or subcontractor to whom it provides PHI pertaining to Covered Entity agrees to the same restrictions and conditions that this Agreement imposes on Business Associate. g. Business Associate agrees to provide an appropriate Individual with access to PHI in a Designated Record Set in the manner required of Covered Entity pursuant to the requirements of 45 CFR §164.524. h. Business Associate agrees to allow an appropriate Individual to make amendment(s) to PHI in a Designated Record Set in the manner required of Covered Entity pursuant to the requirements of 45 CFR §164.526. i. Business Associate agrees to make its internal practices, books, and records (including PHI pertaining to Covered Entity) available to the Secretary for purposes of determining Covered Entity's compliance with the Privacy Rule. j. Business Associate agrees to document disclosures of PHI and information related to these disclosures so it or Covered Entity may respond to requests by Individuals for an accounting of disclosures of PHI pursuant to the requirements of 45 CFR §164.528. k. Business Associate agrees to provide PHI in the possession or control of Business Associate to appropriate Individuals in order to respond to requests for an accounting of disclosures of PHI pursuant to the requirements of 45 CFR §164.528. l. Business Associate.s responses to requests for action with respect to PHI described in this Section II shall be completed in a manner which complies with the timeliness requirements contained in the Privacy Rules. m. Business Associate agrees to notify Covered Entity if there is a breach of unsecure PHI pursuant to the requirements of 45 CFR § § 164.410. III. PERMITTED USES AND DISCLOSURES BY BUSINESS ASSOCIATE a. General Use and Disclosure Provisions. Except as otherwise limited in this Agreement, Business Associate may use or disclose PHI pertaining to Covered Entity for the purposes set forth in the parties. service agreement, if the use or disclosure would not violate the Privacy Rule if done by Covered Entity or violate the minimum necessary policies and procedures of Covered Entity. b. Specific Use and Disclosure Provisions: (i) Except as otherwise limited in this Agreement, Business Associate may use PHI for its own proper management and administration or to carry out its legal responsibilities, provided the disclosures are Required By Law or the Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and will be used or further disclosed only as Required By Law or for the purpose for which it was disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached. (ii) Except as otherwise limited in this Agreement, Business Associate may use PHI to provide Data Aggregation services to Covered Entity as permitted by 45 CFR §164.504(e)(2)(i)(B). (iii) Business Associate may use PHI to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR §164.502(j)(1). IV. OBLIGATIONS OF THE COVERED ENTITY a. To Inform Business Associate. Covered Entity will inform Business Associate of its privacy practices and any agreed restrictions on PHI as follows: (i) Covered Entity shall advise Business Associate of any limitations in the notice of privacy practices that Covered Entity produces in accordance with 45 CFR §164.520, to the extent that such limitation may affect Business Associate's use or disclosure of PHI. (ii) Covered Entity shall notify Business Associate of any changes in, or revocation of, permission by an Individual to use or disclose PHI, to the extent that such changes affect Business Associate's use or disclosure of PHI. (iii) Covered Entity shall notify Business Associate of any restrictions on use or disclosure of PHI that Covered Entity has agreed to in accordance with 45 CFR §164.522, to the extent that such restrictions may affect Business Associate's use or disclosure of PHI. b. Permissible Requests by Covered Entity. Covered Entity shall not request Business Associate to use or disclose PHI in any manner that would violate the Privacy Rule if done by Covered Entity, except that Business Associate may in its discretion use or disclose PHI for Data Aggregation and/or management and administrative activities of Business Associate. V. COMPLIANCE WITH HIPAA SECURITY REGULATIONS a. Business Associate shall: (i) Implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the electronic PHI it creates, receives, maintains or transmits on behalf of Covered Entity as required to comply with HIPAA Security Regulations at 45 CFR Parts 160, 162 and 164. (ii) Ensure that any agents, including but not limited to contractors and subcontractors, to which Business Associate provides PHI pertaining to Covered Entity, agree to implement reasonable and appropriate safeguards to protect it. (iii) Have a system in place to report to Covered Entity any security incident of which Business Associate becomes aware. .Security incident. means the attempted or successful unauthorized access, use, disclosure, modification, or destruction of information or interference with system operations in an information system. VI. STANDARDS FOR ELECTRONIC TRANSACTIONS a. In connection with Standard Transactions, as defined in HIPAA, Business Associate will: (i) Comply with all applicable provisions of the HIPAA Standard for Electronic Transactions Rule on or before the compliance date (the .Transactions Compliance Deadline.) when exchanging information in covered electronic transactions. Business Associate will comply with any future required transactions or code set standards adopted by HHS on or before the required compliance date. .Standards for Electronic Transactions Rule. means the final regulations issued by HHS concerning Standard Transactions and Code Sets under HIPAA Rules, 45 CFR Parts 160 and 162, as may thereafter be amended. .Transactions. means the types of information exchange between two parties to carry out financial or administrative activities related to health care as defined in the Standards for Electronic Transactions Rule. (ii) Ensure that any agents, including but not limited to contractors and subcontractors, that assist Business Associate in conducting Standard Transactions on behalf of Covered Entity, agree in writing to comply with the Standards for Electronic Transactions Rule. (iii) Not change the definition, data condition, or use of any data element or segment. (iv) Not add any data elements or segments to the maximum defined data set in a Standard Transaction. (v) Not use any code or data elements that are either marked .not used. in the standard.s implementation specification or are not in the standard.s implementation specification(s). (vi) Not change the meaning or intent of the standard.s implementation specification(s). VII. TERM AND TERMINATION a. Term. This Agreement shall be effective as of the date stated above and shall terminate when all PHI pertaining to Covered Entity which Business Associate maintains is destroyed or returned to Covered Entity, or, if it is not feasible to return or destroy PHI, protections are extended to such information in accordance with the Termination provisions in this Section . b. Termination for Cause. If Covered Entity or Business Associate learns of a material breach by the other party, it shall: (1) provide a reasonable opportunity for the party to cure the breach or end the violation, or if the party does not cure the breach or end the violation within the time specified by the non-breaching party; (2) immediately terminate this Agreement and any underlying service agreement upon written notice to the breaching party that it has breached a material term of this Agreement and there is no cure. If neither termination nor cure is feasible, the non-breaching party shall report the violation to the Secretary. c. Effect of Termination: (i) Except as provided in paragraph (c)(ii) of this Section VII, upon termination of this Agreement for any reason, Business Associate shall return or destroy all PHI relating to Covered Entity. This provision shall apply to PHI that is in the possession of subcontractors or agents of Business Associate. Business Associate shall retain no copies of this PHI. (ii) In the event that Business Associate reasonably determines that returning or destroying the PHI is not feasible, Business Associate shall provide to Covered Entity notification of the conditions that make return or destruction infeasible. Upon Business Associate's reasonable determination that return or destruction of PHI is infeasible, Business Associate shall extend the protections of this Agreement to such PHI and limit further uses and disclosures of PHI to those purposes that make the return or destruction not feasible, for as long as Business Associate maintains the PHI. VIII. MISCELLANEOUS a. Regulatory References. Reference in this Agreement to a section in the Privacy Rule means the section as in effect or as amended. b. Amendment. The Parties agree to take such action as may be necessary to amend this Agreement from time to time for Covered Entity or Business Associate to comply with the requirements of the Privacy Rule and other requirements of HIPAA. c. Survival. The respective rights and obligations of Business Associate under Sections VII(c)(i) and (ii) of this Agreement shall survive termination of this Agreement. d. Interpretation. Any ambiguity in this Agreement shall be resolved in favor of a meaning that permits Covered Entity or Business Associate to comply with the Privacy Rule and other requirements of HIPAA. This Agreement shall be interpreted without regard to the rule that a document is to be construed against the party which drafts it. e. Complete Integration. This Agreement forms the entire agreement between the parties relating to the subject matter hereof, and supersedes all prior negotiations, discussions, representations, or proposals, whether oral or written, unless expressly incorporated herein. Further, this Agreement may not be modified except in a writing signed by the duly authorized re presentatives of both parties. If any provision or part of this Agreement is found to be invalid, the remaining provisions shall remain in full force and effect. f. Successors and Assigns. This Agreement will inure to the benefit of and be binding upon the successors and assigns of Covered Entity and Business Associate. However, this Agreement is not assignable by either party without the prior written consent of the other party, except that Business Associate may assign or transfer this Agreement to any entity owned or unde r common control with Business Associate. Written consent will not be unreasonably withheld. g. Not a Fiduciary or Plan Administrator. Business Associate shall not be considered a fiduciary or plan administrator of any of Covered Entity's employee benefit plans. h. No Third Party Beneficiaries. This Agreement is entered into for the benefit of Covered Entity and Business Associate. There are no third party beneficiaries to this Agreement. Business Associate's obligations are to Covered Entity only. i. Confidentiality. Except as otherwise provided in the Privacy Rule or this Agreement, neither party will disclose the terms of this Agreement to any third party without the other party's written consent. j. Counterparts. This Agreement may be executed in two or more counterparts, each of which may be deemed an original. k. Indemnification and Hold Harmless. Business Associate agrees to indemnify Covered Entity and hold it harmless from any and all liabilities or damages, including penalties, costs or attorneys. fees, resulting directly or indirectly from Business Associate.s breach of the terms of this Agreement, or resulting directly or indirectly from any breach of the HIPAA Rules by one of Business Associate.s employees, agents or contractors. Covered Entity agrees to indemnify Business Associate and hold it harmless from any and all liabilities or damages, including penalties, costs or attorneys. fees, resulting directly or indirectly from Covered Entity.s breach of the terms of this Agreement, or resulting directly or indirectly from any breach of the HIPAA Rules by one of Covered Entity.s employees, agents or contractors. IX. ACKNOWLEDGEMENT AND SIGNATURES THE PARTIES ACKNOWLEDGE THAT THEY HAVE READ THIS AGREEMENT, UNDERSTAND IT, AND AGREE TO BE BOUND BY ITS TERMS. Business Associate By:__________________________________ Title: ________________________________ Date:________________________________ Covered Entity By:__________________________________ Title: ________________________________ Date:________________________________

Disclosure and Authorization (the .Company.) may procure a consumer report and/or investigative consumer report on you in connection with your request to be offered transcription assignments. Such reports are defined under the Fair Credit Reporting Act. These background reports may be obtained at any time after receipt of your authorization and, if you are engaged by the Company, throughout your contract period. Intelius Screening Solutions LLC, a consumer reporting agency, will obtain the report for the Company. Intelius Screening Solutions is located at 19800 North Creek Parkway, Suite 200, Bothell, WA 98011, and can be reached at (866) 338-6739. The report may contain information bearing on your character, general reputation, personal characteristics, mode of living and/or credit standing. The information that will be included in your report include: credit reports, social security number trace, criminal records checks, public court records checks, driving records checks, educational records checks, verification of employment positions held, personal and professional references checks, and licensing and certification checks. The Company will only request credit reports insofar as they relate to your prospective services for Company. The information contained in the report will be obtained from private and/or public record sources, including sources identified by you or through interviews or correspondence with your past or present coworkers, neighbors, friends, associates, current or former employers, educational institutions or other acquaintances. You have the right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report. Please be advised that the nature and scope of the most common form of investigative consumer report obtained with regard to prospects for transcription is, but may not be limited to a criminal background check, personal & professional reference checks, and licensing & certification checks. Provided to you with this authorization is a Summary of Your Rights Under the Fair Credit Reporting Act in a form prescribed by the Federal Trade Commission. Please do not sign this authorization until you have received this summary. California, Minnesota, and Oklahoma applicants or residents: You have a right to request a free copy of your report if one is ordered on you. Please contact .s Help Desk to receive an emailed copy of your report. ADDITIONAL STATE LAW NOTICES If you are a California, Maine, New York, or Washington state applicant, employee, or contractor, please also note: CALIFORNIA: Pursuant to section 1786.22 of the California Civil Code, you may contact Intelius Screening Solutions during normal business hours (9am to 5pm PST, Monday through Friday) to obtain and review all information in your file. You may obtain such information by appearing in person at Intelius Screening Solutions. offices, during normal business hours and upon reasonable notice, and upon submitting proper identification and paying the costs duplication services. You may be accompanied by one other person, provided that person furnishes proper identification. You may also obtain a copy of your file by certified mail, if you have previously provided identification in a written request that your file be sent to you or a third party identified by you. You may also obtain a summary of your file by telephone, upon providing proper identification. Intelius Screening Solutions has trained personnel available to explain your file to you, including any coded information. CALIFORNIA (En Españ: De acuerdo con el artílo 1786.22 del Cóo Civil, se puede llamar a Intelius Screening Solutions por los horarios normales de trabajo (9 de la mañ a 5 de la tarde, tiempo del pacíco, lunes a viernes) para sacar y examinar su archivo privado en detalle. Para conseguir una copia de su archivo privado, se puede hacer una visita en persona a la oficina de Intelius Screening Solutions por los horarios normales de trabajo, al darnos aviso razonable, al presentarnos de identificaciópropriada, y al pagarnos las cuestas de duplicació Otra persona puede accompañe con tal que tambiése traiga identificaciópropriada. Se puede pedirnos que le mandamos por correo certificado una copia de su archivo privado con tal que hayamos recibido una solicitud escrita que se lo mandemos una copia de su archivo privado a Usted o tal tercer partido que estédentificado por Usted. Tambiése puede pedir por teléno un resumen de su archivo privado, al presentarnos identificaciópropriada. Empleamos trajabadores cualificados, a quienes estádisponibles para explicáelo el contenido de su archivo privado con mádetalles, incluso algunos datos cifrados. MAINE: You have the right, upon request, to be informed of whether an investigative consumer report was requested, and if one was requested, the name and address of the consumer reporting agency furnishing the report. You may request and receive from the Company, within five business days of our receipt of your request, the name, address, and telephone number of the nearest unit designated to handle inquiries for the consumer reporting agency issuing an investigative consumer report concerning you. You also have the right, under Maine law, to request and promptly receive from all such agencies copies of any such reports. NEW YORK: You have the right, upon request, to be informed of whether an investigative consumer report was requested, and if one was requested, the name and address of the consumer reporting agency furnishing the report. At the time you consent to your employer obtaining a report you are entitled to receive a copy of Article 23-A of New York Correction Law. Do not sign your consent until you receive a copy of that law. WASHINGTON: If the Company requests an investigative consumer report, you have the right, upon written request made within a reasonable period of time after your receipt of this disclosure, to receive from the Company a complete and accurate disclosure of the nature and scope of the investigation requested by the Company. You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act. TYPIST AUTHORIZATION I have carefully read and understand this disclosure and authorization form and I have received a copy of the .Summary of Your Rights Under the Fair Credit Reporting Act. provided with this form. I have had the opportunity to review my rights. By my signature below, I consent to the preparation of background reports by Intelius Screening Solutions LLC, and to the release of such reports to the Company and its designated representatives for the purpose of assisting the Company in making a determination as to my eligibility for employment, promotion, retention, contract assignment or for other lawful purposes. I understand that, to the extent allowed by law, information contained in my job application or otherwise disclosed to the Company by me before or during my employment or contract assignment, if any, may be utilized for the purpose of obtaining such consumer reports and/or investigative consumer reports about me. I understand that nothing herein shall be construed as an offer of employment or contract for services. I hereby authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal/state/local), motor vehicle record agencies, my past or present employers, the military, and other individuals or sources to furnish any and all information on me that is requested by the consumer reporting agency. By my signature (including electronic) below, I certify the information provided on and in connection with this form is true, accurate, and complete. I agree that this form in original, faxed, photocopied or electronic form will be valid for any background reports that may be requested by or on behalf of the Company. Dated: ___________________________ First Name: ___________________________ Full Middle Name: ___________________________ Last Name: ___________________________ Signature: ___________________________ *Date of Birth: ___________________________ SSN: ___________________________ Drivers License #: __________________ State of Issue: ___________ *This information is being collected to conduct the background screen on you. It will not be used for any other purpose. Para informacion en espanol, visite www.ftc.gov/credit o escribe a la FTC Consumer Response Center, Room 130-A 600 Pennsylvania Ave. N.W., Washington, D.C. 20580. ASUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy ofinformation 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.ftc.gov/credit or write to: Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Ave. N.W., Washington, D.C. 20580. 1) 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. 2) C 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) a person has taken adverse action against you because of information in your credit b) report; c) you are the victim of identity theft and place a fraud alert in your file; d) your file contains inaccurate information as a result of fraud; e) you are on public assistance; f) you are unemployed but expect to apply for employment within 60 days. In addition, by September 2005 all consumers will be entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.ftc.gov/credit for additional information. 3) 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. 4) You have the right to dispute incomplete or inaccurate information. If you identifyinformation 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.ftc.gov/credit for an explanation of dispute procedures. 5) Consumer reporting agencies must correct or delete inaccurate, incomplete, orunverifiable information. Inaccurate, incomplete or unverifiable information must beremoved or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate. 6) Consumer reporting agencies may not report outdated negative information. In mostcases, 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. 7) 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. 8) You must give your consent for reports to be provided to employers. A consumerreporting agency may not give out information about you to your employer, or a potentialemployer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.ftc.gov/credit. 9) 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 the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-5-OPTOUT (1-888-567-8688). 10) 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.11) Identity theft victims and active duty military personnel have additional rights. For more information, visit www.ftc.gov/credit. States may enforce the FCRA, and many states have their own consumer reporting laws. Insome cases, you may have more rights under state law. For more information, contact yourstate or local consumer protection agency or your state Attorney General. Federal enforcers are: TYPE OF BUSINESS: Consumer reporting agencies, creditors and others not listed below CONTACT: Federal Trade Commission: Consumer Response Center . FCRA Washington, DC 20580 1-877-382-4357 TYPE OF BUSINESS: National banks, federal branches/agencies of foreign banks (word "National" or initials "N.A." appear in or after bank's name) CONTACT: Federal Trade Commission: Consumer Response Center - FCRA Washington, DC 20580 1-877-382-4357 TYPE OF BUSINESS: Federal Reserve System member banks (except national banks, and federal branches/agencies of foreign banks) CONTACT: Federal Trade Commission: Consumer Response Center - FCRA Washington, DC 20580 1-877-382-4357 TYPE OF BUSINESS: Savings associations and federally chartered savings banks (word "Federal" or initials "F.S.B." appear in federal institution's name) CONTACT: Office of Thrift Supervision Consumer Complaints Washington, DC 20552 800-842-6929 TYPE OF BUSINESS: Federal credit unions (words "Federal Credit Union" appear in institution's name) CONTACT: National Credit Union Administration 1775 Duke Street Alexandria, VA 22314 703-519-4600 TYPE OF BUSINESS: State-chartered banks that are not members of the Federal Reserve System CONTACT: Federal Deposit Insurance Corporation Consumer Response Center, 2345 Grand Avenue, Suite 100 Kansas City, Missouri 64108-2638 1-877-275-3342 TYPE OF BUSINESS: Air, surface, or rail common carriers regulated by former Civil Aeronautics Board or Interstate Commerce Commission CONTACT: Department of Transportation , Office of Financial Management Washington, DC 20590 202-366-1306 TYPE OF BUSINESS: Activities subject to the Packers and Stockyards Act, 1921 CONTACT: Department of Agriculture Office of Deputy Administrator - GIPSA Washington, DC 20250 202-720-7051 NEW YORK CORRECTION LAW ARTICLE 23-A New York Bus Code §380-c(b)(2) and 380-g(d) §750. Definitions. For the purposes of this article, the following terms shall have the following meanings: (1) .Public agency. means the state or any local subdivision thereof, or any state or local department, agency, board or commission. (2) .Private employer. means any person, company, corporation, labor organization or association which employs ten or more persons. (3) .Direct relationship. means that the nature of criminal conduct for which the person was convicted has a direct bearing on his fitness or ability to perform one or more of the duties or responsibilities necessarily related to the license, opportunity, or job in question. (4) .License. means any certificate, license, permit or grant of permission required by the laws of this state, its political subdivisions or instrumentalities as a condition for the lawful practice of any occupation, employment, trade, vocation, business, or profession. Provided, however, that .license. shall not, for the purposes of this article, include any license or permit to own, possess, carry, or fire any explosive, pistol, handgun, rifle, shotgun, or other firearm. (5) .Employment. means any occupation, vocation or employment, or any form of vocational or educational training. Provided, however, that .employment. shall not, for the purposes of this article, include membership in any law enforcement agency. §751. Applicability. The provisions of this article shall apply to any application by any person for a license or employment at any public or private employer, who has previously been convicted of one or more criminal offenses in this state or in any other jurisdiction, and to any license or employment held by any person whose conviction of one or more criminal offenses in this state or in any other jurisdiction preceded such employment or granting of a license, except where a mandatory forfeiture, disability or bar to employment is imposed by law, and has not been removed by an executive pardon, certificate of relief from disabilities or certificate of good conduct. Nothing in this article shall be construed to affect any right an employer may have with respect to an intentional misrepresentation in connection with an application for employment made by a prospective employee or previously made by a current employee. §752. Unfair discrimination against persons previously convicted of one or more criminal offenses prohibited. No application for any license or employment, and no employment or license held by an individual, to which the provisions of this article are applicable, shall be denied or acted upon adversely by reason of the individuals having been previously convicted of one or more criminal offenses, or by reason of a finding of lack of .good moral character. when such finding is based upon the fact that the individual has previously been convicted of one or more criminal offenses, unless: (1) There is a direct relationship between one or more of the previous criminal offenses and the specific license or employment sought or held by the individual; or (2) the issuance or continuation of the license or the granting or continuation of the employment would involve an unreasonable risk to property or to the safety or welfare of specific individuals or the general public. §753. Factors to be considered concerning a previous criminal conviction; presumption. 1. In making a determination pursuant to section seven hundred fifty.two of this chapter, the public agency or private employer shall consider the following factors: (a) The public policy of this state, as expressed in this act, to encourage the licensure and employment of persons previously convicted of one or more criminal offenses. (b) The specific duties and responsibilities necessarily related to the license or employment sought or held by the person. (c) The bearing, if any, the criminal offense or offenses for which the person was previously convicted will have on his fitness or ability to perform one or more such duties or responsibilities. (d) The time which has elapsed since the occurrence of the criminal offense or offenses. (e) The age of the person at the time of occurrence of the criminal offense or offenses. (f) The seriousness of the offense or offenses. (g) Any information produced by the person, or produced on his behalf, in regard to his rehabilitation and good conduct. (h) The legitimate interest of the public agency or private employer in protecting property, and the safety and welfare of specific individuals or the general public. 2. In making a determination pursuant to section seven hundred fifty.two of this chapter, the public agency or private employer shall also give consideration to a certificate of relief from disabilities or a certificate of good conduct issued to the applicant, which certificate shall create a presumption of rehabilitation in regard to the offense or offenses specified therein. §754. Written statement upon denial of license or employment. At the request of any person previously convicted of one or more criminal offenses who has been denied a license or employment, a public agency or private employer shall provide, within thirty days of a request, a written statement setting forth the reasons for such denial. §755. Enforcement. 1. In relation to actions by public agencies, the provisions of this article shall be enforceable by a proceeding brought pursuant to article seventy.eight of the civil practice law and rules. 2. In relation to actions by private employers, the provisions of this article shall be enforceable by the division of human rights pursuant to the powers and procedures set forth in article fifteen of the executive law, and, concurrently, by the New York city commission on human rights.

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