Consumer Report Disclosure Form

OCC Clean may order a consumer report on you from Datasource, Inc. (“Datasource”), 1200 NW South Outer Road, Suite 319, Blue Springs, MO 64015, (877) 577-3832, a consumer reporting agency, in connection with your application for employment. If you are hired or already work for the Company, it may order additional consumer reports on you from Datasource for employment purposes.

The consumer reports may contain information concerning your character, general reputation, personal characteristics, credit standing, and mode of living. To the extent allowed by law, the reports may contain information regarding: public records; driving records; verification of your prior employment, licenses, credentials, and education; credit reports; government watch lists; address history; Social Security number validation; and other background checks.