Information Customer Service

AUTHORIZATION TO PROCURE AN

INVESTIGATIVE CONSUMER REPORT

Wells Fargo (the "Company") intends to procure an investigative consumer report on your background (a

"Report") from First Advantage P.O. Box 3367, Seminole, Florida 33775-3367, 800-***-**** ext. 8. In preparing the Report, First Advantage may conduct a criminal records search, and may verify your education and employment history. The Report could include information about your criminal history, academic achievement, employment history, Social Security Number verification, character, general reputation, personal characteristics, and mode of living. The Company may use the information contained in these Reports to make decisions regarding your eligibility for employment or continued employment with the Company. If you are hired by the Company, it may also procure subsequent Reports for employment purposes (including, without limitation, to make decisions regarding retention, reassignment or promotion) unless this authorization is revoked in writing.

Please accurately complete the information requested below. You understand that any false statement, misrepresentation, or omission of facts on this authorization, or otherwise provided to the Company through First Advantage, is grounds for rejection of your employment application or immediate termination of employment, regardless of when the Company discovers the false statement, misrepresentation or omission of facts.

Before the Company takes any adverse action regarding your application for or any subsequent employment with the Company based in whole or in part on information obtained in a Report, you will be provided with a copy of the Report and a written description of your rights under the Fair Credit Reporting Act. If you disagree with the accuracy of any information In either of these Reports, you must notify the Company within 5 business days of your receipt of the Report that you are challenging the accuracy of the information contained in the report.

By your signature below, you authorize the Company to procure a Report and subsequent Reports about you and to consider the Report(s) when making decisions regarding your application for and any subsequent employment with the Company. You must fill out this form within two (2) business days after you receive it.

You hereby authorize any and all persons, business entities, credit agencies and governmental agencies

(collectively, "Third Parties") who may have information relevant to the Report(s) to disclose such information to the Company by and through First Advantage or Equifax. You hereby release the Company, First Advantage and all Third Parties to the full extent permitted by law, from any liability or claims arising from retrieving and/or reporting information concerning you and/or from using the Report for employment purposes. . I authorize First Advantage and the Company to provide Wells Fargo copies of all background reports concerning this disclosure.

For more information about your rights under the federal Fair Credit Reporting Act, please go to www.ftc.gov/credit or see below.

I have read A Summary of Your Rights Under the FCRA If I am an applicant or resident of New York I have read New York Article 23A. If you would like to receive a copy of the consumer report obtained by First Advantage, the option to request it will be presented later in the process. If you are a California applicant, you have the right to visually inspect the files concerning you maintained by an investigative consumer reporting agency during normal business hours and upon reasonable notice. The inspection can be done in person, by request by certified mail to have materials sent to you, or by phone, if proper identification is provided. You also can request trained personnel to explain information to you including coded information, and you can be accompanied by a representative. If you are a Minnesota applicant, you have the right to make a written request to the consumer reporting agency, First Advantage, for a complete and accurate disclosure of the nature and scope of the consumer report.

NOTICE TO APPLICANTS/EMPLOYEES OR INDIVIDUALS BEING CONSIDERED FOR PLACEMENT

BASED ON OR ARISING FROM

FEDERAL BUREAU OF INVESTIGATION (FBI) FINGERPRINT CRIMINAL HISTORY RECORD

CHECK (CHRI)

A Federal Bureau of Investigation (FBI) Criminal Justice Information Services Division (CJIS) related report based on the fingerprints you have submitted will be used to check your Criminal History Record Information (CHRI) as provided in Federal Bureau of Investigation (FBI) records. The information in the FBI CHRI records may also be further investigated as necessary. Should you believe that the information in the FBI report is incorrect or incomplete and you wish to dispute any of the information contained in the FBI report, DO NOTcontact First Advantage, instead you must directly contact the law enforcement agency that provided the information to the Federal Bureau of Investigations.

TITLE 28 - JUDICIAL ADMINISTRATION

CHAPTER I - DEPARTMENT OF JUSTICE

PART 16 - PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION subpart c - PRODUCTION OF FBI IDENTIFICATION RECORDS IN RESPONSE TO WRITTEN REQUESTS BY SUBJECTS THEREOF

16.34 - Procedure to obtain change, correction or updating of identification records. If, after reviewing his/her identification record, the subject thereof believes that it is incorrect or incomplete in any respect and wishes changes, corrections or updating of the alleged deficiency, he/she should make application directly to the agency which contributed the questioned information.

The subject of a record may also direct his/her challenge as to the accuracy or completeness of any entry on his/her record to the FBI, Criminal Justice Information Services (CJIS) Division, ATTN: SCU, Mod. D2, 1000 Custer Hollow Road, Clarksburg, WV 26306. The FBI will then forward the challenge to the agency which submitted the data requesting that agency to verify or correct the challenged entry. Upon the receipt of an official communication directly from the agency which contributed the original information, the FBI CJIS Division will make any changes necessary in accordance with the information supplied by that agency.

Signature

Consent And Authorization

I have read and accept the terms of this Online Application. First Name: KERRI

Last Name: ROBERTS

Country: UNITED STATES

Address 1: 3150 s Woodward st

Address 2:

City: Springfield

Region: Illinois

Zip Code/Postal: 62703

Date: September 9, 2016

I consent

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