DISCLOSURE REGARDING CONSUMER AND/OR INVESTIGATIVE REPORT

THIS DOCUMENT CONTAINS IMPORTANT INFORMATION. PLEASE READ IT CAREFULLY.

This process is in English, except for critical disclosures that are provided in select languages.

In order to evaluate candidate suitability for employment (including contract for service), Amazon.com "the Company" has implemented a policy of pre-employment screening worldwide.

In connection with your application for employment, the Company has engaged Accurate Background to conduct pre- employment screening on its behalf.

Screening services are generally defined as, but are not limited to: criminal and civil records checking; education, qualification and employment history verification. The nature and scope of the screening will be relevant to the position for which you have applied and might not include all possible checks. All screening will be conducted to the extent applicable law allows.

Information collected from you will be used solely to assess your suitability for employment and for execution of the employment contract, and will not be used for another purpose.

Accurate Background may also need to disclose your information to third parties such as governmental agencies, educational institutions, previous employers and research partners who can assist in verifying the information you have provided. Data will be stored on a secure server in the United States, in accordance with Safe Harbor and international (including UK and Ireland) data protection standards.

Your data may be transferred outside of the European Economic Area (EEA) and/or any other country as applicable if this is nec essary to complete the pre-employment screening process.

For more information about Accurate Background's data protection and privacy policies, please visit the website at
http://www.accuratebackground.com/site-harbor-policy.php?sec=6

The consumer and/or investigative consumer report(s) will be obtained from:
Accurate Background, Inc., 7515 Irvine Center Dr. Irvine, CA 92618, 00.800.2224.3252
Accurate Background's information and privacy policy can be found at www.accuratebackground.com.

Review and complete the following information:
Do you have any unspent criminal convictions? If yes, please provide details below. Please do not report spent convictions for which the record has been sealed, expunged or for which you have received a pardon. Reporting a criminal conviction may not necessarily disqua lify you from the position to which you applied.

YesNo

If yes, please briefly explain the type of offense, date and location of the occurrence and the disposition.

CRIMINAL RECORD DISCLOSURE FORM

NAME(S) MrMrsMissOther





BIRTH DETAILS

IDENTIFICATION NUMBERS

UK Passport: YesNo


CURRENT ADDRESS





PREVIOUS ADDRESS HISTORY - Most recent first - 7 YEARS REQUIRED

























DECLARATION
I declare that, to the best of my knowledge the above is true and correct.
Signature:


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I give Accurate Background and their representative’s permission to:

Obtain information on criminal convictions I may have which are unspent according to the Rehabilitation of Offenders Act 1974; use and store my personal information, including anything that is sensitive, for the sole purpose of performing the background check; contact me directly to get any information Accurate Background needs to carry out Basic Disclosure checks on me and to verify my information before passing it on to my current or new employer (or people acting for them); give my information to other organisations—such as local and central governments, the police, courts and tribunals, and legal advisers—for them to use only as necessary to process the background check; and give my personal information to my current or new employer to the extent applicable law allows.

Permission to use information under the Data Protection Act 1998:
I give all government organisations and others permission to give Accurate Background and my current or new employer (or people acting for them) information about my background (including information about my driving records, criminal records, and other public records) to determine my suitability for employment. I agree that my
personal information can be used outside of the European Economic Area, in accordance with applicable law, if this is necessary for employment screening purposes. I also give Accurate Background and their representative’s permission to give my personal information to other organisations if required to carry out the checks. I understand that all handling of my personal information by Accurate Background and other organizations will be limited to performing the background check.

By signing below I confirm that I have read and understood Accurate background’s privacy policy regarding personal information (shown on the website at http://www.accuratebackground.com/siteharbor-policy.p?sec=6)



Signature:


True and Complete Statement:
I declare that the information provided in this form and any other documents submitted by me are true and complete. I underst and and agree that any false information or omission by me may result in the rejection of my application, or if I am employed, the termination of employment. In order to access my suitability for employment (including contract for service), I understand that Amazon.co.uk Limited will conduct pre- employment screening and has engaged Accurate Background, Inc. to verify the information I have provided including, but not limited to: criminal and civil records; education, qualification and employment history, and; driving and credit records. I understand that the information I provide will be verified, and research will be conducted using the appropriate sources and to the extent relevant law allows. I consent, without reservation, for the Company and its representatives to conduct pre-employment screening, and I further authorize organisations in any country to assist and provide any information necessary to complete this verification process. I agree to my personal information being transferred outside of the European Economic area and/or any other country as applicable if this is necessary to conduct the pre-employment screening
process.

Signature:


ACKNOWLEDGMENT AND AUTHORIZATION FOR BACKGROUND CHECK

By submitting your information, you consent to the collection, use and storage of your information as outlined above. You also authorize organizations in any country to give your personal information to the organizations referred to above, and to your employer to the extent applicable law allows.

Your consent will apply unless you revoke or cancel it by sending a signed letter or statement to the Company at any time.

Candidate declaration
I understand the information presented above.

I consent, without reservation, to the Company and its representatives to conduct pre-employment screening, and I further authorize organizations in any country to assist and provide any information necessary to complete this verification process.

I acknowledge receipt of the DISCLOSURE REGARDING CONSUMER AND/OR INVESTIGATIVE REPORT and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and certify that I have read and understand both of those documents. I hereby authorize the obtaining of "consumer reports" and/or "investigative consumer reports" by the Company at any time after receipt of this authorization and throughout my employment, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, local, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by Accurate Background, Inc., 7515 Irvine Center Dr. Irvine, CA 92618, 00.800.2224.3252, www.accuratebackground.com, another outside organization acting on behalf of the Company, and/or the Company itself.

I understand that by signing below, that I am providing the Authorization form directing the background check as described above, and I certify that:

• I have received the Disclosure Regarding Consumer and/or Investigative Report, have read and received the Summary of Your
Rights, and if a California resident/applicant, the A Summary of Your Rights Under the Provisions of California Civil Code §1786.22.

• I understand that my electronic signature now and throughout this process will be binding as though I had physically signed these documents by hand. Additionally, notices, documents, and communications may be provided electronically and will meet the requirements set forth under Federal and/or State law, as permitted by law. I agree that a facsimile ("fax"), electronic or printout of this authorization may be accepted with the same authority as the original.


Signature: