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Allison & Taylor, Inc.
1-800-890-5645 Toll Free (USA) 248-460-4300 Fax www.allisontaylor.com
Consent to Check References and Records/ Authorization to Release Confidential Information
Please review the following information. Your signature below constitutes your agreement to these policies and verification that all information in this application is true and correct.
I authorize Allison & Taylor, Inc. and it agents to verify information provided by me on my application, including employment references, education, credit history and any background information they may find available regarding criminal history, for purposes of confirming my background, education and previous employment/work experience.
I authorize the entities listed as references on my application to disclose only to Allison & Taylor, Inc. and its agents any and all information related to my work habits and performance, including attendance, reliability, reason for leaving, and eligibility for rehire, without giving me prior notice of such disclosure.
Alex Bray 9/12/2018 Signature________________________________________ Date___________________
Legal Name____________________________________________________________
Alexander Joseph Bray
Address________________________________________________________________
Seattle 98117 City__________________________________State____W_A_________Zip_____________
8008 21st Avenue NW
Telephone ______________________________________________________________
619-723-7267
Social Security Number______________________________________________
523-51-2241
Date of Birth _______________________
Confidentiality Notice: This message constitutes a confidential communication. It is intended exclusively for the individual or entity to which it is addressed. If you are not the named addressee, you are not authorized to read, print, retain, copy or disseminate this message or any part of it. If you have received this message in error, please notify the sender immediately by e-mail and delete all copies of this message.
This document is the proprietary confidential property of Allison & Taylor, Inc. and its agents or contractors. Disclosure or discussion of this document, in whole or in part, to any party other than that intended and/or duplication, distribution, or publication of this document, in whole or in part, is strictly prohibited according to the laws of the State of Michigan. Nothing in this message is intended to constitute an electronic signature unless a specific statement to the contrary is included in this message.
9/19/1980
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