Option 2 United Technologies Contractors ChoicePoint Expedited Background Check Process




Дата канвертавання27.04.2016
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OPTION 2

United Technologies Contractors

ChoicePoint Expedited Background Check Process
You have requested to have a background check expedited for an individual within your company. The normal turnaround time for the credentialing process is 2-3 weeks. This expedited process will allow you to submit a background check request and bypass the 2-3 week credentialing. Because of certain data security and steps outside of our normal process, the following items should be noted:
If you have any questions regarding this process contact ChoicePoint by calling 866.441.5290 or emailing: utc@choicepoint.com.


  1. No results will be returned directly to the contractor company. There are no exceptions.

  2. A $20 processing fee is added in addition to the cost of background. This covers the cost of additional handling required.

  3. A credit card must be supplied for the charges of the report. A separate invoice cannot be mailed or created.

  4. A United Technologies contact must be provided with fax number to have results sent to.


Step 1: Complete Credit Card Authorization Form and return to ChoicePoint
Complete page 2 for each individual that is required to complete the employee background screening process for a UTC company and fax to 770.752.6170 or email scanned image to ccrd.payments@choicepoint.com.
Step 2: Complete Fax Order Form, Consumer Notification & Authorization and Contractor Information Form and return to ChoicePoint
Complete pages 3-6 for each individual who is required to complete the employee background screening process for a UTC company and fax the completed forms to ChoicePoint at 866-661-2331.


Credit Card Authorization Form

United Technologies Contractors

Expedited Background Check Process
Fax completed form to 770.752.6170 or email scanned image to ccrd.payments@choicepoint.com for payment processing.


Name on Credit Card ____________________________________________



Type of Credit Card______________________________________________


Credit Card Number______________________________________________

Expiration Date _________________________________________________

Applicant Information (Contractor to have background processed)

First Name Last Name Social Security Number

Account Number 137470EXP
Authorized Dollar Amount $44.00 per report plus Court Fees* and Motor Vehicle Report fee if applicable.
Check here if a Motor Vehicle Report will be requested because a badge is needed for a FL Pratt & Whitney location. $3.25 will be charged to your card in addition to $44.00 plus Court Fees.
*Court Fees are incurred when counties or states charge for searching if an individual has a criminal record. These fees are passed through to the client in addition to fee listed above.

Signature_______________________________________________________




FAX ORDER FORM

United Technologies Contractors

Account # 137470 – EXP


UTC CONTACT INFORMATION (List the United Technologies Corporation contact to receive completed background results. For Pratt and Whitney in CT, see the web page where you accessed this form for UTC Contact information.)
UTC Contact Name:_________________________________________________________________

First Last
Phone #:___________________________________________ Fax #:_____________________________________

***Results are to be faxed here only***


APPLICANT INFORMATION (Contractor to have background processed)
_____________________________________________________ _______________________________________

First Last Social Security Number
________________________________________________________________________________________________

Current Address City State Zip

Contractor / Vendor Company Name: _________________________________________________________________________________

Requestor Name: _____________________________________________ Phone #:______________________________________________

FAX TO: 866-661-2331

Please perform the following services:

 5 Year Multi-County FAM Criminal Record Search (Residence Only)

 National Criminal file

 Social Security Search (SSNV)



Please provide 5 years of residence history:

(City)_______________________(County)_____________(State)_______(Zip)_

(City)_______________________(County)_____________(State)_______(Zip)_

(City)_______________________(County)_____________(State)_______(Zip)_



 Motor Vehicle Report (Select this search type if you are a contractor for Pratt & Whitney in FL ONLY.)

NOTE: The Consumer Notification & Authorization and Contractor Information Form must accompany this order form. Please complete all applicable information required to initiate above searches.

Consumer Notification & Authorization


This is used to inform you that a consumer report or an investigative consumer report is being obtained from a consumer reporting agency for the purpose of evaluating a contracting engagement at United Technologies and / or any of their subsidiaries.


This report may contain information bearing on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living from public record sources or through personal interviews with your neighbors, friends or associates. You may also have a right to request additional disclosures regarding the nature and scope of the investigation.
TO Whom it May Concern:
I hereby authorize and request any present or former employer, school, police department, financial institution, agency or other persons having personal knowledge about me, to furnish bearer with any and all information in their possession regarding me in connection with an application for employment, including consumer report information that may include motor vehicle records. I am willing that a photocopy of this authorization be accepted with the same authority as the original, and I specifically waive any written notice from any present or former employer who may provide information based upon this authorized request. I understand this authorization is to be part of the written employment application which I sign.
I have been given a copy of this form.
Print Name ________________________________________________________________
Signature

________________________________________________________________


Date of Birth (for identification purposes only) _________________________________
Social Security Number (for identification purposes only) _________________________
List any other names previously used:

________________________________________________________________


MN & Oklahoma Residents please note: In connection with your application for employment, your consumer report may be obtained and reviewed. Under Minnesota and Oklahoma law, you have a right to receive a free copy of your consumer report by checking the appropriate box below.
___ YES, I am a Minnesota resident and would like a free copy of my consumer report.

___ YES, I am an Oklahoma resident and would like a free copy of my consumer report.


CA Residents please note: In connection with your application for employment, your credit report will be obtained and reviewed. Under CA law, you have a right to receive a free copy of your credit report by checking the appropriate box below. Your credit report will be mailed to you by the credit bureau. In the alternative, you may elect to receive the entire investigative consumer report, which will include your credit report.
___ YES, I am a California resident and would like a free copy of my credit report; or

___ YES, I am a California resident and would like a free copy of my investigative consumer report.



Contractor Information Form


    Applicant Name___________________________________________________________

    Last First Middle

    Previous Legal Name__________________________________________________________

    Last First Middle

    Social Security # _________-_______-____________

    Date of Birth ______________________________________________

    (Identification purposes only-Include Month/Day/Year)

    Drivers’ License #_______________________ State Issued________





LIST ALL RESIDENTIAL ADDRESSES WITHIN THE LAST 5 YEARS




Current Address
Street Address___________________________________________
City_____________________________ State__________ Zip Code_________
Previous Addresses
Street Address___________________________________________
City_____________________________ State__________ Zip Code_________
Street Address___________________________________________
City_____________________________ State__________ Zip Code_________
Street Address___________________________________________
City_____________________________ State__________ Zip Code_________







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