QuickTate : Transcribers

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Typing and Analyzing Files for Quicktate and iDictate

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

Who we are

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

Quicktate 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 several hours.

IDictate transcribes all types of files, except for voicemail messages.

What we require of our contractors

Accurate spelling and punctuation.
Individuals that know how to follow instructions.
Typists that can listen to voice files and accurately type what they hear.
Experienced and professional transcriptionists.
Typists with their own equipment, supplies, facilities (office/ work space).
Honesty, integrity and reliability.
No convictions of a felony or misdemeanor on your record. (Do not proceed if you have ever been convicted)
Take a typing quiz for each language or specialty you are interested in (examples: English, Spanish, French, Medical, etc.). You may also be given an opportunity to be tested to analyze audio files.
Take a test to ensure you understand Quicktate's requirements.
Depending on how you scored on your Quicktate typing test, you may qualify to be tested to also offer your services to iDictate.

As an Independent Contractor, you can select your own hours that you want to work. You can work as few, or as many hours as you want. We are open for business 24 hours/ day; 7 days/ week.

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

The following must be done in order.

Review and follow all procedures and requirements outlined in our Help Desk.
Review and follow all procedures and requirements outlined in the HIPAA Business Associate Agreement (below).
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.
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.
Carefully review all postings to our Help Desk frequently, so that you are up to date on Quicktate and iDictate issues. This should provide you with answers to any of your questions.
Take our Quiz so we can determine if we can offer you assignments (see our Help Desk for details https://quicktate.zendesk.com/). Answer each question and fill out the form completely.
Background Checks: After you pass the Quiz and the typing test, we will run a background check on you. You agree to pay the $20 cost of the background check. This may be paid using PayPal or credit card.

When you click "I Agree" below, you are also agreeing to the following:

I acknowledge that I am offering my services as an independent contractor to iDictate and/or Quicktate ("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.

This agreement supersedes and replaces any and all prior agreements between the Parties.

Sign up to Request Quicktate Assignments

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Your First Name

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I have Word Perfect YesNo

I have Excel YesNo

I have Express Scribe Pro YesNo

References

We require three references.

First Reference

Name Phone Number Email Relation

Second Reference

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Third Reference

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Agreements

Click here to read the agreements Quicktate Typist Handbook, Company Policies and Code of Ethics

Typist Handbook, Company Policies and Code of Ethics

Quicktate

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 Quicktate.

II. COMPANY POLICIES AND CODE OF ETHICS

General:
- No contractor shall defraud the Company or its clients by deliberately or willfully transcribing, pasting, entering, or otherwise providing transcripts, responses, text or other data intended for the Company or its clients which is clearly not reflective or related to the audio or other files provided by Company or its clients for typing, translating, or processing. Contractor and Company acknowledge that such acts of fraud could cause irreparable harm to the Company. Accordingly, since damages for such fraud would be difficult to ascertain, the parties agree that contractor shall be liable to Company for liquidated damages in the amount of Five Thousand Dollars ($5,000) for each instance of such fraud. The prevailing Party in any such action shall be entitled to recover, in addition to liquidated damages, the costs and expenses of enforcement, including reasonable collection and attorney's fees.

- 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.

Quicktate Confidentiality Agreement

Quicktate Confidentiality Agreement

1. Quicktate 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 Quicktate 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: Quicktate 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 Quicktate.

4. Quicktate 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 Quicktate.

- 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 Quicktate. At any time at Quicktate's option or promptly upon Quicktate's request, you shall return to Quicktate 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 Quicktate or any of its customers or clients in public or private and shall not
request any Quicktate customer to cancel its business with Quicktate. You shall not divert or try to divert any Quicktate customer to another similar company or help any other similar company obtain any business from any Quicktate customer without the written
consent of Quicktate.

HIPAA Business Associate Agreement.

BUSINESS ASSOCIATE AGREEMENT


This Business Associate Agreement (the "Agreement") is made and entered into this _____ day of ________________, _____, by and between iDictate and Quicktate ("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 ß 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 ß160.103, and shall include a person who qualifies as a personal representative in accordance with 45 CFR ß164.502(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 ß164.103.

(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 ß164.524.

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 ß164.526.

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 ß164.528.

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 ß164.528.

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 ß ß 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 ß164.504(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 ß164.520, 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 ß164.522, 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, Authorization & Consent for the Procurement of Consumer Reports

Section I: Disclosure

iDictate and Quicktate (the "Company") may request background information about you from a consumer reporting agency in connection with your employment application and for employment purposes. The report ordered is defined by the Fair Credit Reporting Act (FCRA) as a Consumer Report, and all inquiries are limited to information that affects job performance and the workplace. It is conducted in accordance with applicable federal and state laws including the FCRA. The screening will be conducted by an outside agency: Inflection Risk Solutions, LLC d/b/a GoodHire - Address: P.O. Box 391403 Omaha, NE 68139 | Phone: 1-888-906- 7351 | Fax: 650-362-1933 | Email: support@goodhire.com. As a result, GoodHire may obtain a Consumer Report on you as an applicant or during employment.

A consumer report is a compilation of information that might affect your employability. The scope of the report may include information concerning your driving record, civil and criminal court records, credit, drug screening results, worker's compensation record, education, credentials, identity, past addresses, social security number, previous employment and personal references.

Should an employer rely upon a consumer report for an adverse action, the FCRA mandates you be provided with a copy of the consumer report and a summary of your rights. An adverse action is defined as "a denial of employment or any other decision for employment purposes that adversely affects any current or prospective employee."

Section II: Authorization and Release

I have carefully read and understand this Candidate Disclosure, Authorization & Consent for the Procurement of Consumer Reports form and the attached summary of rights under the Fair Credit Reporting Act. By my signature below, I authorize the company to share the contents of this consumer report or investigative consumer report with its partners and clients in an effort to place me into an employment/independent contractor relationship with those partners. I understand that if the Company hires me, my consent will apply, and the Company may obtain reports, throughout my employment. I also understand that information contained in my job application or otherwise disclosed by me before or during my employment, if any, may be used for the purpose of obtaining consumer reports and/or investigative consumer reports. By my signature below, I authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal, state and local), motor vehicle records agencies, my past or present employers, the military, and other individuals and sources to furnish any and all information on me that is requested by the consumer reporting agency. By my signature below, I certify the information I provided on this form is true and correct and will be valid for any reports that may be requested by or on behalf of the Company.

I authorize GoodHire and its agents to contact my current employer if necessary to verify my current employment status after the following date:

Applicant Name:______________________	Applicant Email:_____________________
Applicant Signature:__________________	Date:______________________________

Check this box to receive a free copy of any Consumer Report, Investigative Consumer Report or Credit Report from GoodHire electronically. For a paper copy, contact GoodHire at 1-888-906-7351 or support@goodhire.com.

Section III: A Summary of Rights Under The FCRA

Para información en español, 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 identity 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 many 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).
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:

TYPE OF BUSINESS:	PLEASE CONTACT:
1.a. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates b. Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the CFPB:	Consumer Financial Protection Bureau 1700 G Street, N.W. Washington, DC 20552 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 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 c. Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associations d. Federal Credit Unions	a. Office of the Comptroller of the Currency Customer Assistance Group 1301 McKinney Street, Suite 3450 Houston, TX 77010-9050 b. Federal Reserve Consumer Help Center P.O. Box. 1200 Minneapolis, MN 55480 c. FDIC Consumer Response Center 1100 Walnut Street, Box #11 Kansas City, MO 64106 d. 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 Avenue, S.E. Washington, DC 20590
4. Creditors Subject to the Surface Transportation Board	Office of Proceedings, Surface Transportation Board Department of Transportation 395 E Street, S.W. Washington, DC 20423
5. Creditors Subject to the Packers and Stockyards Act, 1921	Nearest Packers and Stockyards Administration area supervisor
6. Small Business Investment Companies	Associate Deputy Administrator for Capital Access United States Small Business Administration 409 Third Street, S.W., 8th Floor Washington, DC 20416
7. Brokers and Dealers	Securities and Exchange Commission 100 F Street, N.E. 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

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