Va Form 0710 PDF Details

In the landscape of safeguarding personal information amid growing concerns for privacy and security, the VA 0710 form emerges as a critical document for individuals connected with the Department of Veterans Affairs. Standing as a testament to the importance of consent in the era of information, this authorization form delineates a structured process for the release of personal credit information under the protective canopy of the Fair Credit Reporting Act (Title 15, Section 1681). It empowers the Department of Veterans Affairs Security Office to conduct thorough investigations by obtaining credit reports, with a clear stipulation that no adverse actions would be taken solely based on these reports. Furthermore, it assures that any adverse action, if necessary, would be accompanied by a comprehensive explanation, including the individual's rights as outlined by the Federal Trade Commission. This document not only manifests an individual's consent for the release of sensitive financial data to accredited federal representatives but also reinforces the commitment to observe equal employment opportunity laws and regulations in its use. By signing this form, employees or affiliated individuals authorize the sharing of their financial and credit history, underscoring the trust placed in the VA's investigatory processes. The validity of this authorization, extending up to five years or till the termination of affiliation with the Department of Veterans Affairs, indicates a temporal boundary within which this permission remains in effect, assuring individuals of a controlled use of their personal information. The form, designed with clarity, ensures legibility and ease of use, marking a significant step in the meticulous handling of sensitive information within the framework of federal employment and security clearance processes.

QuestionAnswer
Form NameVa Form 0710
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesVA_Form_0710 va form 0710pdffillercom

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AUTHORIZATION FOR RELEASE OF INFORMATION

PROTECTED UNDER THE FAIR CREDIT REPORTING ACT (TITLE 15, SECTION 1681)

STATEMENT OF AUTHORIZATION AND CLARIFICATION OF PURPOSE

I AUTHORIZE the Department of Veterans Affairs Security Office to obtain Credit Reports from the Credit Bureau and other Consumer Reporting Agencies, Collection Agencies, and Retail Business Establishments which hold financial and credit information.

The Security Office will not take adverse action against the subject of investigation, based in whole or in part upon the results of the credit report. Should adverse action occur, the VA will provide a copy of the report and a written description of the subject's rights as described by the FTC under Section 1681g (c)(3) of Title

15.Any information from the consumer report, in violation of any applicable equal employment opportunity law or regulation, will not be used in the adjudication of the investigation.

I AUTHORIZE custodians of records and other sources of information pertaining to me to release such information upon the request of the investigator, special agent, or other duly accredited representative of any Federal agency authorized above regardless of any previous agreement to the contrary.

I UNDERSTAND that the information released by records custodians and sources of information is for official use by the Department of Veterans Affairs, Office of Security and Law Enforcement, only for the purposes of the adjudication and establishment of eligibility/security clearance.

Copies of this authorization that show my signature are as valid as the original release signed by me. This authorization is valid for (5) years from the date signed or upon the termination of my affiliation with the Department of Veterans Affairs, whichever is sooner.

SIGNATURE OF EMPLOYEE (Sign in ink)

TYPE OR PRINT LEGIBLY FULL NAME

DATE SIGNED

OTHER NAMES USED

HOME TELEPHONE NUMBER (Include Area Code)

CURRENT ADDRESS (Include Street, City, State, and ZIP Code)

VA FORM

0710

AdobeFormsDesign

MAY 1998

 

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