DHS Form 11000-9 PDF Details

In the realm of employment within the Department of Homeland Security (DHS), the DHS 11000 9 form serves as a critical tool, pivotal for both the employer and potential or current employees. This form, acting under the guidance of the Fair Credit Reporting Act, is instrumental in the process of acquiring consumer or credit reports for individuals in the context of employment. Such reports are sought for a variety of reasons, crucial among them being to assess suitability for hiring, promotion, or other employment-related decisions that might necessitate access to classified or sensitive information. The process is rooted in consent, requiring individuals to authorize DHS explicitly to obtain these reports, thereby ensuring awareness and agreement on part of the potential or current employee. This authorization is not just a formality; it's a gateway that allows DHS to make informed decisions about an individual’s eligibility and fitness for certain roles within the department, leveraging background checks as a key component of security and integrity in employment practices. Additionally, the form touches on mandatory legal disclosures, informing individuals about the use of their Social Security Number (SSN) — a crucial identifier in the process of obtaining a credit report. It highlights the balance between necessity and privacy, adhering to federal requirements while ensuring individuals are fully informed about the nature of information solicitation and its implications in the sphere of employment and security clearance within the DHS.

QuestionAnswer
Form Name DHS Form 11000-9
Form Length 1 pages
Fillable? No
Fillable fields 0
Avg. time to fill out 15 sec
Other names dhs form pertaining print, dhs 11000, dhs form 11000 9, form 11000 9

Form Preview Example

DEPARTMENT OF HOMELAND SECURITY

DISCLOSURE AND AUTHORIZATION

PERTAINING TO CONSUMER REPORTS

PURSUANT TO THE FAIR CREDIT REPORTING ACT

This is a release for the Department of Homeland Security to obtain one or more

consumer/credit reports about you in connection with your application for employment or

in the course of your employment with the Department. One or more reports about you

may be obtained for employment purposes, including evaluating your fitness for

employment, promotion, reassignment, retention, or access to classified information

and/or sensitive, but unclassified information.

I,,hereby authorized the Department of Homeland Security to obtain such report(s) from any consumer/credit reporting agency for employment purposes. Copies of this authorization that show my signature are as valid as the original signed by me.

Signature

Date

Social Security Number

Organization Assigned

Street Address:_______________________________________________________________________

City:___________________________________________ State:_______ Zip Code :______________

Email Address: ______________________________________________________

The Privacy Act, 5 U.S.C. 552a, requires that federal agencies inform individuals, at the time information is solicited from them, whether the disclosure is mandatory or voluntary, by what authority such information is solicited, and what uses will be made of the information. You are hereby advised that authority for soliciting your Social Security Number (SSN) is Executive Order 9397. Your SSN will be used to identify you precisely when it is necessary to conduct and/or obtain a credit report on you. Although the disclosure of your SSN is not mandatory, your failure to do so may impede the acquisition of a credit report concerning you and possibly result in the denial of your being approved for access to classified and/or sensitive, but unclassified

information.

DHS Form 11000-9 (10/08) (FEMA edit 2017)

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form 11000 9 conclusion process detailed (step 1)

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