Harbor Freight Application PDF Details

The Harbor Freight Application Form marks the beginning for those aspiring to join a company committed to providing equal employment opportunities. This comprehensive form is designed with meticulous care to ensure every candidate, regardless of race, age, sex, disability, sexual orientation, or other protected characteristics, receives fair consideration. Applicants are encouraged to detail their interest in the company by indicating the position they are applying for, their availability, and their ability to legally work in the country, in addition to a summary of their employment history and qualifications. The form also addresses the capacity of the applicant to perform job-related functions, taking into account any accommodations that might be necessary. Furthermore, it incorporates sections dedicated to emergency contacts and personal references, enhancing the company’s understanding of the applicant. Emphasizing transparency and honesty, it outlines the expectation for accurate information provided by applicants and the consequences of falsification. Additionally, it underscores the company’s policies around searches, discrimination, and sexual harassment, ensuring candidates are aware of Harbor Freight Tools’ commitment to a respectful workplace. With a robust section on employment history and an accompanying supplement for detailed entries, this application form is a pivotal step in Harbor Freight’s hiring process, reflecting the company's thorough approach to gathering pertinent applicant information while adhering to legal and ethical hiring standards.

QuestionAnswer
Form NameHarbor Freight Application
Form Length7 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 45 sec
Other namesonline application for harbor freight, harbor freight jobs, harbor freight com careers, harbor freight com application

Form Preview Example

Equal Opportunity: All

applicants will be given equal consideration regardless of race, age, sex, physical or mental disability, sexual orientation, ancestry, pregnancy, or other medical condition, marital status, color, religion, national origin, or veteran

status.

PLEASEPRINTIN INK

HARBOR FREIGHT TOOLS

Application For Employment (NOT an offer for employment)

Note: Please print your responses and sign this application in ink. Individuals will not be considered an applicant if they exclude 1.) position applied for and date, 2.) information required by law such as authorization to work in the U.S., 3.) a complete employment history including name of employer, dates of employment, rate of pay and reason for leaving, and 4.) signature of applicant.

POSITION APPLIED FOR _________________________________________________ DATE _____________

 

 

 

How Did You Learn of this Position? Newspaper

 

 

 

School

Walk-in

Referral (Name _______________)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME

 

 

 

 

 

 

 

 

 

 

 

 

TELEPHONE

NO. 1 ( ____ ) _______________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last

 

First

 

 

 

 

Middle

 

 

 

TELEPHONE NO. 2 ( ____ ) _______________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

 

City

 

 

 

 

 

 

 

 

 

State

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you under 18?

Yes

No

If Yes, do you have (or will you get) a work permit?

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Have you been employed by this company before? Yes

 

 

 

 

No

 

 

 

Does your relative work here? Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you currently employed?

Yes

No

 

 

 

 

 

 

When can you start work here? _______________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you eligible for employment in this country? Yes

 

 

 

No

 

 

 

(Proof of eligibility will be required upon employment)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Can we leave a message to contact you? Yes

 

 

 

No

 

 

 

 

 

 

If yes, phone no. ____________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type of Employment Desired:

Full Time

 

Part Time

 

 

 

 

 

Temporary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shift Desired: Day

 

Evening

Night

 

 

 

 

 

 

 

 

Hours available to work: *

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mon.

 

Tue.

Wed.

Thur.

Fri.

Sat.

Sun.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you willing to work overtime if required?

 

 

 

From

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

To

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Have you been convicted of a misdemeanor or felony

 

 

 

 

 

 

 

 

 

 

Note: Convictions do not automatically disqualify an applicant

 

 

 

 

 

 

 

 

 

in the last seven years?

Yes

 

No

If yes,

from further consideration. However, offers of employment (or the

 

 

 

 

 

 

 

 

 

please explain:

 

 

 

 

 

 

 

 

 

continued employment of newly hired employees) are contingent

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

upon criminal, background, and for some positions, credit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

investigation findings which conform to overall company hiring

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

standards or are applicable to specific position requirements.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you able to perform the essential functions of the job applied for with or without reasonable

 

 

 

 

 

 

 

 

 

accommodation? For retail/warehouse, typical job functions in this company involve employees to bend, squat, kneel twist, work at heights

 

 

 

 

 

 

 

 

 

intermittently, pushing and pulling of materials, reaching and working above and below shoulder level, lift and carry items weighing 25 to 75 pounds,

 

 

 

 

 

 

 

 

 

work cordially with the public. For office, duties involve sitting continuously throughout the day; simple grasping, pushing, and pulling of materials;

 

 

 

 

 

 

 

 

 

stand, walk, bend squat and kneel intermittently; operate computer keyboards and 10-key calculator throughout the day; lift and carry items up to 25

 

 

 

 

 

 

 

 

 

lbs.; read written communications and understand verbal communication over the phone. Are you able to perform? Yes

No

If no, please

 

 

 

 

 

 

 

 

 

explain. Attach extra sheet as necessary. Do not provide medical information.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

* Please note: Regardless of work schedules, regular and prompt attendance is required of all employees and is an essential function of all positions.

_________________________________________________________________________________________

IN CASE OF EMERGENCY NOTIFY:

__________________________________________________________________________________________

NameAddress City State Phone

PERSONAL REFERENCE: Provide the name of one person, not related to you, whom you have known for at least one year.

_________________________________________________________________________________________________________________

Name

address

city

state

phone No.

years known

APPLICATION FOR EMPLOYMENT HARBOR FREIGHT TOOLS PAGE1 1/06

(If necessary, to account for for all

_________________________________ PAGE 2 1/06

EDUCATION

(Circle the last year completed)

Elementary School

5

6

7

8

High School

1

2

3

4

College

1

2

3

4

Highest degree obtained: ______ Name of school/college: __________________

Describe other training or education:

_________________________________________________________

___________________________________________________________

Describe office/warehouse equipment you can operate (i.e. forklifts, computers, etc.)

______________________________________

______________________________________

______________________________________

______________________________________

______________________________________

_________________________________

NAME

EMPLOYMENT HISTORY —- List your three most recent employers, starting with the most recent, including military experience. Please explain gaps in employment in the COMMENTS section below.

experience within the last 10 years, also complete SUPPLEMENT TO APPLICATION FOR EMPLOYMENT.)

Employer

____________________________________ Telephone (_____) _________________ Dates Employed: From ____________

To ____________

Address

______________________________________________________________________________________________________________________________

 

street

city

state

zip code

Job Title _______________________________________________ Starting hourly rate/salary: $__________ Final hourly rate/salary: $___________

Immediate Supervisor Name/Title _______________________________ Telephone # (_____) _______________

May we contact this person for a reference? Yes No

Summarize the nature of your work and your duties _____________________________________________________________________________________________

______________________________________________________________________________________________________________________________________

Why did you leave this employer?

HARBOR FREIGHT TOOLS —- APPLICATION FOR EMPLOYMENT

Employer ________________________________________ Telephone (_____) _________________ Dates Employed: From ____________

To ___________

Address ______________________________________________________________________________________________________________________________

street

city

state

zip code

Job Title _______________________________________________

Starting hourly rate/salary: $__________ Final hourly rate/salary: $___________

Immediate Supervisor Name/Title _______________________________ Telephone # (_____) _______________

May we contact this person for a reference? Yes No

Summarize the nature of your work and your duties _____________________________________________________________________________________________

Why did you leave this employer?

 

 

 

 

 

 

 

Employer ________________________________________ Telephone (_____) _________________ Dates Employed: From ____________

To ____________

Address ______________________________________________________________________________________________________________________________

street

city

state

zip code

Job Title _______________________________________________

Starting hourly rate/salary: $__________ Final hourly rate/salary: $___________

Immediate Supervisor Name/Title _______________________________ Telephone # (_____) _______________

May we contact this person for a reference? Yes No

Summarize the nature of your work and your duties ______________________________________________________________________________________________

Why did you leave this employer?

COMMENTS: (Explain ALL gaps in employment)

Please read and sign:

I hereby certify that the information in this application is true and correct to the best of my knowledge and agree to have any of the information verified by this organization unless I have indicated in writing to the contrary. I authorize the references listed above, as well as other individuals who the company or the company’s agents contacts, to provide any and all information concerning my previous employment and any other pertinent information that they may have. Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information to the company as well as from the use or disclosure of such information by the company or any of its agents, employees, or representatives. I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer or, if I am hired, my immediate dismissal from employment. I agree to conform to the rules and standards of the company, as amended from time to time at its discretion. I agree that my employment and compensation can be terminated at will, with or without cause, and with or without notice, at any time, either at my option or at the option of the company. I understand that the company reserves the right to search all employees/persons and all parcels, packages, lunch boxes, coats, bags, containers, lockers, boxes and belongings, etc. on property controlled by the company at all times. The aforementioned right-to-search is a condition of employment. No written or oral promise of employment for a specified term is effective unless expressly set forth in a document signed by an officer of the company. I understand that I am advised not to resign current employment until after an official offer of employment by this company is extended. It is company policy to provide an environment free of discrimination or sexual harassment and if any such discrimination or harassment takes place, I will report it to a manager or a personnel representative immediately. I hereby acknowledge that I have read and fully understand the above statements, including the statement concerning company rules and the “Right-to-Search” statement.

NAME OF APPLICANT (Print) ___________________________________________________________

SIGNATURE OF APPLICANT__________________________________________________ DATE ___________________

COMPANY USE ONLY: Reviewer signature______________________ Manager signature_____________________________date______

HARBOR FREIGHT TOOLS - SUPPLEMENT TO APPLICATION FOR EMPLOYMENT

(This is a supplemental sheet which references and incorporates all information, instructions, authorizations, and provisions of Applicant's completed Application for Employment.)

EMPLOYMENT HISTORY - Continued from Application For Employment Form — Applicant: Use as many of these sheets as is necessary to account for the LAST 10 YEARS of your work experience. Please explain gaps in employ- ment in the comments section below (or on an additional/separate sheet).

APPLICANT NAME (PRINT)

Employer___________________________________Telephone (

)___________________________Dates Employed: From_________To________

Address___________________________________________________________________________________________________________________

street

city

state

zip code

Job Title____________________________________Starting hourly rate/salary: $________________Final hourly rate/salary $__________________

Immediate Supervisor Name/Title__________________Telephone ( )_______________May we call this person for a reference? Yes No

Summarize the nature of your work and your duties________________________________________________________________________________

__________________________________________________________________________________________________________________________

Why did you leave this employer?______________________________________________________________________________________________

Employer___________________________________Telephone (

)___________________________Dates Employed: From_________To________

Address___________________________________________________________________________________________________________________

street

city

state

zip code

Job Title____________________________________Starting hourly rate/salary: $________________Final hourly rate/salary $__________________

Immediate Supervisor Name/Title__________________Telephone ( )_______________May we call this person for a reference? Yes No

Summarize the nature of your work and your duties________________________________________________________________________________

__________________________________________________________________________________________________________________________

Why did you leave this employer?______________________________________________________________________________________________

Employer___________________________________Telephone (

)___________________________Dates Employed: From_________To________

Address___________________________________________________________________________________________________________________

street

city

state

zip code

Job Title____________________________________Starting hourly rate/salary: $________________Final hourly rate/salary $__________________

Immediate Supervisor Name/Title__________________Telephone ( )_______________May we call this person for a reference? Yes No

Summarize the nature of your work and your duties________________________________________________________________________________

__________________________________________________________________________________________________________________________

Why did you leave this employer?______________________________________________________________________________________________

COMMENTS: (Explain all gaps in employment)

_________________________________________________________________________________________________

_________________________________________________________________________________________________

THIS IS SHEET_____OF_____SHEETS SUBMITTED AS SUPPLEMENT TO APPLICATION FOR EMPLOYMENT

SIGNATURE OF APPLICANT______________________________________________DATE______________________

21719/3

HARBOR FREIGHT TOOLS 1/04

 

 

 

 

 

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NOTICE: This form is the property of A-Check America, Inc. No alterations to its content may be made without the prior written consent of its author. Any changes made without A-Check’s authorization are considered a breach of contract.

IMPORTANT NOTICE TO APPLICANT

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act (FCRA) is designed to promote accuracy, fairness, and privacy of information if the files of every "consumer reporting agency" (CRA). Most CRA's are credit bureaus that gather and sell information about you - such as if you pay your bills on time or have filed bank- ruptcy - to creditors, employers, landlords, and other busi- nesses. You can find the complete text of the FCRA, 15 U.S.C. 1681-1681u, at the Federal Trade Commission's web site (http://www.ftc.gov). The FCRA gives you specific rights, as outlined below. You may have additional rights under state law. You may contact a state or local consumer protection agency or a state attorney general to learn those rights.

You must be told if information in your file has been used against you. Anyone who uses information from a CRA to take action against you - such as denying an application for credit, insurance, or employment - must tell you, and give you the name, address, and phone number of the CRA that provided the consumer report.

You can find out what is in your file. At your request, a CRA must give you the information in your file, and a list of everyone who has requested it recently. There is no charge for the report if a person has taken action against you be- cause of information supplied by the CRA, if you request the report within 60 days of receiving notice of the action you also are entitled to one free report every twelve months upon request if you certify that (1) you are unemployed and plan to seek employment within 60 days, (2) you are on welfare, or (3) your report is inaccurate due to fraud. Otherwise, a CRA may charge you up to eight dollars.

You can dispute inaccurate information with the CRA. If you tell a CRA that your file contains inaccurate informa- tion, the CRA must investigate the items (usually within 30 days) by presenting to its information source all relevant evi- dence you submit, unless your dispute is frivolous. The source must review your evidence and report its findings to the CRA. (The source also must advise national CRA's - to which it has provided the data - of any error). The CRA must give you a written report of the investigation results in any change. If the CRA's investigation does not resolve the dispute, you may add a brief statement to your file. The CRA must normally include a summary of your statement in future reports. If an item is deleted or a dispute statement is filed, you may ask that anyone who has recently received your report be noti- fied of the change.

Inaccurate information must be corrected or deleted. A CRA must remove or correct inaccurate or unverified information from its files, usually within 30 days after you dispute it. How- ever, the CRA is not required to remove accurate data from your file unless it is outdated (as described below) or cannot be verified. If your dispute results in any change to your re- port, the CRA cannot reinsert into your file a disputed item unless the information source verifies its accuracy and com- pleteness. In addition, the CRA must give you a written no- tice telling you it has reinserted the item. The notice must include the name, address and phone number of the informa- tion source.

You can dispute inaccurate items with the source of the information. If you tell anyone - such as a creditor who re- ports to a CRA - that you dispute an item, they may not then report the information to a CRA without including a notice of your dispute. In addition, once you've notified the source

of the error in writing, it may not continue to report the infor- mation if it is, in fact, an error.

Outdated information may not be reported. In most cases, a CRA may not report negative information that is more than seven years old; ten years for bankruptcies.

Access to your file is limited. A CRA - may provide infor- mation about you only to people with a need recognized by the FCRA - usually to consider an application with a credi- tor, insurer, employer, landlord, or other business.

Your consent is required for reports that are provided to employers, or reports that contain medical information. A CRA may not give out information about you to your em- ployer, or prospective employer, without your written con- sent. A CRA may not report medical information about you to creditors, insurers, or employers without your permission.

You may choose to exclude your name from CRA lists for unsolicited credit and insurance offers. Creditors and insur- ers may use file information as the basis for sending you un- solicited offers of credit or insurance. Such offers must in- clude a toll-free phone number for you to call if you want your name and address removed from future lists. If you call, you must be kept off the lists for two years. If you request, complete, and return the CRA form provided for this pur- pose, you must be taken off the lists indefinitely.

You may seek damages from violators. If a CRA, a user or (in some cases) a provider of CRA data, violates the FCRA, you may sue them in state or federal court.

The FCRA gives several different federal agencies authority to enforce the FCRA:

For Questions or Concerns Regarding:

Please Contact:

CRAs, creditors and others not listed below

Federal Trade Commission

 

Consumer Response Center - FCRA

 

Washington, DC 20580

 

202-326-3761

 

 

National banks, federal branches/agencies

Office of the Controller of the

of foreign banks (word "National" or

Currency/Compliance Management

initials "N.A." appear in or after bank's

Mail Stop 6-6

name)

Washington, DC 20219

 

800-613-6743

 

 

Federal Reserve System member banks

Federal Reserve Board

(except national banks, and federal

Consumer and Community Affairs

branches/agencies of foreign banks)

Washington, DC 20551

 

202-452-3693

 

 

Savings associations and federally

Office of Thrift Supervision

chartered savings banks (word "Federal"

Consumer Programs

or initials "F.S.B." appear in federal

Washington, DC 20552

institution's name)

800-842-6929

 

 

Federal credit unions (words "Federal

National Credit Union Admin.

Credit Union" appear in institution's

1775 Duke Street

name)

Alexandria, VA 22314

 

703-518-6360

 

 

State-chartered banks that are not

Federal Deposit Insurance Corp.

members of the Federal Reserve System

Division of Compliance &

 

Consumer Affairs

 

Washington, DC 20429

 

800-934-FDIC

 

 

Air, surface, or rail common carriers

Department of Transportation

regulated by former Civil Aeronautics

Office of Financial Management

Board or Interstate Commerce Commission

Washington, DC 20590

 

202-366-1306

Activities subject to the Packers and

Department of Agriculture

Stockyards Act, 1921

Office of Deputy Administrator -

 

GIPSA

 

Washington, DC 20250

 

202-720-7051

21719

NOTICE TO USERS OF CONSUMER REPORTS: OBLIGATIONS OF USERS UNDER THE FCRA

The federal Fair Credit Reporting Act (FCRA) requires that this notice be provided to inform users of consumer reports of their legal obligations. State law may impose additional requirements. The first section of this summary sets forth the responsibilities imposed by the FCRA on all users of con- sumer reports. The subsequent sections discuss the duties of users of reports that contain specific types of information, or that are used for certain purposes, and the legal consequences of violations. The FCRA, 15 U.S.C. 1681-1681u, is set forth in full at the Federal Trade Commission's Internet web site (http://www.ftc.gov).

I.OBLIGATIONS OF ALL USERS OF CONSUMER REPORTS

A. Users Must Have a Permissible Purpose

Congress has limited the use of consumer reports to protect consumer's privacy. All users must have a permissible pur- pose under the FCRA to obtain a consumer report. Section 604 of the FCRA contains a list of the permissible purposes under the law.

These are:

As ordered by a court or a federal grand jury subpoena. Section 604(a)(1)

As instructed by the consumer in writing.

Section 604(a)(2)

For the extension of credit as a result of an application from a consumer, or the review or collection of a consumer's account. Section 604(a)(3)(A)

For employment purposes, including hiring and promotion decisions, where the consumer has given written permission. Sections 604(a)(3)(B) and 604(b)

For the underwriting of insurance as a result of an application from a consumer. Section 604(a)(3)(C)

When there is a legitimate business need, in connection with a business transaction that is initiated by the consumer. Section 604(a)(3)(F)(i)

To review a consumer's account to determine whether the consumer continues to meet the terms of the account. Section 604(a)(3)(F)(ii)

To determine a consumer's eligibility for a license or other benefit granted by a governmental instrumentality required by law to consider an applicant's financial responsibility or status. Section 604(a)(3)(D)

For use by a potential investor or servicer, or current insurer, in a valuation or assessment of the credit or prepayment risks associated with an existing credit obligation. Section 604(a)(3)(E)

For use by state and local officials in connection with the determination of child support payments, or modifications and enforcement thereof. Sections 604(a)(4) and 604(a)(5)

In addition, creditors and insurers may obtain certain con- sumer report information for the purpose of making unsolic- ited offers of credit or insurance. The particular obligations of users of this "prescreened" information are described in Section V below.

B. Users Must Provide Certifications

Section 604(f) of the FCRA prohibits any person from ob- taining a consumer report from a consumer reporting agency (CRA) unless the person has certified to the CRA (by a gen- eral or specific certification, as appropriate) the permissible purpose(s) for which the report is being obtained and certi- fies that the report will not be used for any other purpose.

C. Users Must Notify Consumers When Adverse Actions Are Taken

The term "adverse action" is defined very broadly by Section 603 of the FCRA. "Adverse actions" include all business, credit, and employment actions affecting consumers that can be considered to have a negative impact - such as unfavor- ably changing credit or contract terms or conditions, denying or canceling, credit or insurance, offering credit on less fa- vorable terms than requested, or denying employment or pro- motion.

1. Adverse Actions Based on Information Obtained From a CRA.

If a user takes any type of adverse action that is based at least in part on information contained in a consumer report, the user is required by Section 615(a) of the FCRA to notify the consumer. The notification may be done in writing, orally, or by electronic means. It must include the following:

The name, address, and telephone number of the CRA (including a toll-free telephone number, if it is a nationwide CRA) that provided the report.

A statement that the CRA did not make the adverse decision and is not able to explain why the decision was made.

A statement setting forth the consumer's right to obtain a free disclosure of the consumer's file from the CRA if the consumer requests the report within 60 days.

A statement setting forth the consumer's right to dispute directly with the CRA the accuracy or completeness of any information provided by the CRA.

2.Adverse Actions Based on Information Obtained From Third Parties Who Are Not

Consumer Reporting Agencies:

If a person denies (or increases the charge for) credit for per- sonal, family, or household purposes based either wholly or partly upon information from a person other than a CRA, and the information is the type of consumer information cov- ered by the FCRA, Section 615(b)(1) of the FCRA requires that the user clearly and accurately disclose to the consumer his or her right to obtain disclosure of the nature of the infor- mation that was relied upon by making a written request within 60 days of notification. The user must provide the disclosure within a reasonable period of time following the consumer's written request.

3.Adverse Actions Based on Information Obtained From Affiliates:

If a person takes an adverse action involving insurance, em- ployment, or a credit transaction initiated by the consumer, based on information of the type covered by the FCRA, and this information was obtained from an entity affiliated with the user of the information by common ownership or control, Section 615(b)(2) requires the user to notify the consumer of the adverse action. The notification must inform the consumer that he or she may obtain a disclosure of the nature of the information relied upon by making a written request within 60 days of receiving the adverse action notice. If the con- sumer makes such a request, the user must disclose the na- ture of the information not later than 30 days after receiving the request. (Information that is obtained directly from an affiliated entity relating solely to its transactions or experi- ences with the consumer, and information from a consumer report obtained from an affiliate are not covered by Sction 615(b)(2).)

APPLICANT: Please read and keep this document.

Applicant Survey

Work Opportunity Tax Credit Program

Harbor Freight Tools is participating in the Work Opportunity Tax Credit program. This program is designed by the federal government to help companies hire more people into the workforce and to retain employees through federal incentives.

Your response to the questions below will help us determine if Harbor Freight Tools qualifies for this program. Any information you provide will be kept confidential and will not affect your job, wages, or taxes. Thank you in advance for your time and participation.

Check here if any of the following statements apply to you:

I am a member of a family that has received Temporary Assistance for Needy Families (TANF) for any of the following:

During the last four years

Stopped being eligible for TANF within the last two years because of limitations on how long the benefit

.could be received

I was referred here by a rehabilitation agency approved by the state or the Department of Veteran Affairs.

I am 18-39 years of age and I am a member of a family that received food stamps within the last two years.

I received Supplemental Security Income (SSI) benefits within the last two months.

Within the past year, I was convicted of a felony or released from prison for a felony.

I am a veteran and either:

A member of a family that received food stamps within the last two years

Entitled to compensation for a service-connected disability

Check here if none of the statements above apply to you. (N/A)

Name __________________________________________________________ Date ____________________________

Please keep this form in your store employee file. For warehouse or corporate locations, please send this form to Human Resources.

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