419975 - Club Janitorial Attendant

Feb 29, 2024

Investigative Consumer Report Disclosure

INVESTIGATIVE CONSUMER REPORT DISCLOSURE

24 Hour Fitness USA, LLC (the "Company") may request an investigative consumer report on you. An investigative consumer report is a type of consumer report that involves personal interviews
conducted for the Company by a consumer reporting agency (CRA), commonly with an individual's prior employers or references. The investigative consumer report may include information
about your character, general reputation, personal characteristics, and/or mode of living. You have the right to request more information about the nature and scope of any investigative
consumer report obtained on you by contacting the Company.

Additionally, the federal Fair Credit Reporting Act gives you specific rights in dealing with CRAs. You will find these rights summarized in a separate document titled A Summary of Your Rights
Under the Fair Credit Reporting Act.

PLEASE PROCEED TO THE NEXT DOCUMENT: "A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT"

Reviewed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
A Summary of Your Rights Under the FCRA
Para informacion en espanol, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer
reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a
summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial
Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

● You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or
employment -- or to take another adverse action against you -- must tell you, and must give you the name, address, and phone number of the agency that provided the information.

● You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your "file disclosure"). You will be
required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:

● a person has taken adverse action against you because of information in your credit report;
● you are the victim of identity theft and place a fraud alert in your file;
● your file contains inaccurate information as a result of fraud;
● you are on public assistance;
● you are unemployed but expect to apply for employment within 60 days.

In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See
www.consumerfinance.gov/learnmore for additional information.

● You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from
consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit
score information for free from the mortgage lender.

● You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the
agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.

● Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected,
usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.

● Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old,
or bankruptcies that are more than 10 years old.

● Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need -- usually to consider an application with a creditor, insurer,
employer, landlord, or other business. The FCRA specifies those with a valid need for access.

● You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without
your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.

● You may limit "prescreened" offers of credit and insurance you get based on information in your credit report. Unsolicited "prescreened" offers for credit and insurance must include a toll-free
phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-567-8688.

● The following FCRA right applies with respect to nationwide consumer reporting agencies:

CONSUMERS HAVE THE RIGHT TO OBTAIN A SECURITY FREEZE

You have a right to place a "security freeze" on your credit report, which will prohibit a consumer reporting agency from releasing information in your credit report without your express
authorization. The security freeze is designed to prevent credit, loans, and services from being approved in your name without your consent. However, you should be aware that using a
security freeze to take control over who gets access to the personal and financial information in your credit report may delay, interfere with, or prohibit the timely approval of any subsequent
request or application you make regarding a new loan, credit, mortgage, or any other account involving the extension of credit.

As an alternative to a security freeze, you have the right to place an initial or extended fraud alert on your credit file at no cost.An initial fraud alert is a 1-year alert that is placed on a
consumer's credit file.Upon seeing a fraud alert display on a consumer's credit file, a business is required to take steps to verify the consumer's identity before extending new credit.If you are a
victim of identity theft, you are entitled to an extended fraud alert, which is a fraud alert lasting 7 years.

A security freeze does not apply to a person or entity, or its affiliates, or collection agencies acting on behalf of the person or entity, with which you have an existing account that requests
information in your credit report for the purposes of reviewing or collecting the account.Reviewing the account includes activities related to account maintenance, monitoring, credit line
increases, and account upgrades and enhancements.

● You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the
FCRA, you may be able to sue in state or federal court.

● Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.

States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local
consumer protection agency or your state Attorney General. For information about your federal rights, contact:
Reviewed Yes
California Disclosure Document
CALIFORNIA DISCLOSURE DOCUMENT

24 Hour Fitness USA, LLC (the "Company") may order an "investigative consumer report" (a background check report) on you in connection with your employment or application for employment
(including independent contractor or volunteer assignments, as applicable). The investigative consumer report may contain information about your character, general reputation, personal
characteristics, and mode of living. As allowed by law, such reports may contain the following information pertaining to you: credit history; public records; a Social Security number verification;
driving records; military service; credentials/certifications; and verification of prior employment and education. The Company may not order an investigative consumer report about you without
your written authorization (which you may provide through a separate document called the Authorization for Background Checks).

The agency conducting the investigation and preparing the background report for the Company is ADP Screening and Selection Services, Inc. (ADP SASS), at 2950 East Harmony Road, Suite 130,
Fort Collins, CO, 80528; phone number 800-367-5933; website, http://www.adpselect.com. This website contains information concerning ADP SASS' privacy practices.

A Summary of Your Rights Under the Provisions of California Civil Code Section 1786.22

(a) An investigative consumer reporting agency shall supply files and information required under Section 1786.10 during normal business hours and on reasonable notice.

(b) Files maintained on a consumer shall be made available for the consumer's visual inspection, as follows:

(1) In person, if he appears in person and furnishes proper identification. A copy of his file shall also be available to the consumer for a fee not to exceed the actual costs of duplication
services provided.

(2) By certified mail, if he makes a written request, with proper identification, for copies to be sent to a specified addressee. Investigative consumer reporting agencies complying with
requests for certified mailings under this section shall not be liable for disclosures to third parties caused by mishandling of mail after such mailings leave the investigative consumer reporting
agencies.

(3) A summary of all information contained in files on a consumer and required to be provided by Section 1786.10 shall be provided by telephone, if the consumer has made a written
request, with proper identification for telephone disclosure, and the toll charge, if any, for the telephone call is prepaid by or charged directly to the consumer.

(c) The term "proper identification" as used in subdivision (b) shall mean that information generally deemed sufficient to identify a person. Such information includes documents such as a valid
driver's license, social security account number, military identification card, and credit cards. Only if the consumer is unable to reasonably identify himself with the information described above,
may an investigative consumer reporting agency require additional information concerning the consumer's employment and personal or family history in order to verify his identity.

(d) The investigative consumer reporting agency shall provide trained personnel to explain to the consumer any information furnished him pursuant to Section 1786.10.

(e) The investigative consumer reporting agency shall provide a written explanation of any coded information contained in files maintained on a consumer. This written explanation shall be
distributed whenever a file is provided to a consumer for visual inspection as required under Section 1786.22.

(f) The consumer shall be permitted to be accompanied by one other person of his choosing, who shall furnish reasonable identification. An investigative consumer reporting agency may
require the consumer to furnish a written statement granting permission to the consumer reporting agency to discuss the consumer's file in such person's presence.

Reviewed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
San Francisco Fair Chance Ordinance
Reviewed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
New York Correction Law - Article 23-A
NEW YORK CORRECTION LAW

ARTICLE 23-A

LICENSURE AND EMPLOYMENT OF PERSONS PREVIOUSLY

CONVICTED OF ONE OR MORE CRIMINAL OFFENSES

Section 750. Definitions.

751. Applicability.

752. Unfair discrimination against persons previously convicted of one or more criminal offenses prohibited.

753. Factors to be considered concerning a previous criminal conviction; presumption.

754. Written statement upon denial of license or employment.

755. Enforcement.

§750. Definitions. For the purposes of this article, the following terms shall have the following meanings:

(1) "Public agency" means the state or any local subdivision thereof, or any state or local department, agency, board or commission.

(2) "Private employer" means any person, company, corporation, labor organization or association which employs ten or more persons.

(3) "Direct relationship" means that the nature of criminal conduct for which the person was convicted has a direct bearing on his fitness or ability to perform one or more of the duties or
responsibilities necessarily related to the license, opportunity, or job in question.

(4) "License" means any certificate, license, permit or grant of permission required by the laws of this state, its political subdivisions or instrumentalities as a condition for the lawful practice of
any occupation, employment, trade, vocation, business, or profession. Provided, however, that "license" shall not, for the purposes of this article, include any license or permit to own, possess,
carry, or fire any explosive, pistol, handgun, rifle, shotgun, or other firearm.

(5) "Employment" means any occupation, vocation or employment, or any form of vocational or educational training. Provided, however, that "employment" shall not, for the purposes of this
article, include membership in any law enforcement agency.

§751. Applicability. The provisions of this article shall apply to any application by any person for a license or employment at any public or private employer, who has previously been convicted
of one or more criminal offenses in this state or in any other jurisdiction, and to any license or employment held by any person whose conviction of one or more criminal offenses in this state
or in any other jurisdiction preceded such employment or granting of a license, except where a mandatory forfeiture, disability or bar to employment is imposed by law, and has not been
removed by an executive pardon, certificate of relief from disabilities or certificate of good conduct. Nothing in this article shall be construed to affect any right an employer may have with
respect to an intentional misrepresentation in connection with an application for employment made by a prospective employee or previously made by a current employee.

§752. Unfair discrimination against persons previously convicted of one or more criminal offenses prohibited. No application for any license or employment, and no employment or license held by
an individual, to which the provisions of this article are applicable, shall be denied or acted upon adversely by reason of the individual's having been previously convicted of one or more
criminal offenses, or by reason of a finding of lack of "good moral character" when such finding is based upon the fact that the individual has previously been convicted of one or more criminal
offenses, unless:

(1) There is a direct relationship between one or more of the previous criminal offenses and the specific license or employment sought or held by the individual; or

(2) the issuance or continuation of the license or the granting or continuation of the employment would involve an unreasonable risk to property or to the safety or welfare of specific
individuals or the general public.

§753. Factors to be considered concerning a previous criminal conviction; presumption.

1. In making a determination pursuant to section seven hundred fifty-two of this chapter, the public agency or private employer shall consider the following factors:

(a) The public policy of this state, as expressed in this act, to encourage the licensure and employment of persons previously convicted of one or more criminal offenses. (b) The specific duties
and responsibilities necessarily related to the license or employment sought or held by the person. (c) The bearing, if any, the criminal offense or offenses for which the person was previously
convicted will have on his fitness or ability to perform one or more such duties or responsibilities.

(d) The time which has elapsed since the occurrence of the criminal offense or offenses.

(e) The age of the person at the time of occurrence of the criminal offense or offenses.

(f) The seriousness of the offense or offenses.

(g) Any information produced by the person, or produced on his behalf, in regard to his rehabilitation and good conduct.

(h) The legitimate interest of the public agency or private employer in protecting property, and the safety and welfare of specific individuals or the general public.

2. In making a determination pursuant to section seven hundred fifty-two of this chapter, the public agency or private employer shall also give consideration to a certificate of relief from
disabilities or a certificate of good conduct issued to the applicant, which certificate shall create a presumption of rehabilitation in regard to the offense or offenses specified therein.

§754. Written statement upon denial of license or employment. At the request of any person previously convicted of one or more criminal offenses who has been denied a license or
employment, a public agency or private employer shall provide, within thirty days of a request, a written statement setting forth the reasons for such denial.

§755. Enforcement.

1. In relation to actions by public agencies, the provisions of this article shall be enforceable by a proceeding brought pursuant to article seventy-eight of the civil practice law and rules.

2. In relation to actions by private employers, the provisions of this article shall be enforceable by the division of human rights pursuant to the powers and procedures set forth in article fifteen
of the executive law, and, concurrently, by the New York city commission on human rights.

Reviewed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
Additional Background Check Disclosures
ADDITIONAL BACKGROUND CHECK DISCLOSURES

DISCLOSURE FOR REGULATED TRANSPORTATION POSITIONS: The consumer reporting agency ADP Screening and Selection Services, Inc. (ADP SASS) will prepare the consumer report (background
report) for 24 Hour Fitness USA, LLC (the "Company"). ADP SASS is located at 2950 East Harmony Road, Suite 130, Fort Collins, CO, 80528, and can be reached by phone at 800-367-5933 or at
www.adpselect.com. ADP SASS does not make any decisions to take adverse action. If the Company makes a decision to take adverse action based in whole or in part on the consumer report,
ADP SASS will not be able to provide specific reasons why the adverse action was taken.

You have the right to obtain a free copy of a consumer report on you from the consumer reporting agency which prepared your background report, under various circumstances, including but
not limited to where you receive notice that an adverse action has been taken toward you based on the consumer report. In that instance, you have the right to a free copy of the report
provided that you make the request within 60 days of the date that you received the notice of adverse action. You have the right to dispute, with the consumer reporting agency, the accuracy or
completeness of any information in a consumer report furnished by the agency.

If you live or work for the Company in any of the states below, please note that additional rights may apply to you. These rights are in addition to the rights that federal law grants to everyone
nationwide.

MASSACHUSETTS: If you submit a request to the Company in writing, you have the right to know whether the Company ordered an investigative consumer report from ADP Screening and
Selection Services, Inc. (ADP SASS). An investigative consumer report may include any or all of the following pertaining to you, as allowed by law: credit history; public records; a Social Security
number verification; driving records; military service; credentials/certifications; and verification of prior employment and education. You may inspect and order a free copy of the report by
contacting ADP SASS at: 2950 East Harmony Road, Suite 130, Fort Collins, CO, 80528; (telephone) 800-367-5933; or www.adpselect.com.

MINNESOTA: If you submit a request to ADP Screening and Selection Services, Inc. (ADP SASS) in writing, you have the right to receive a complete and accurate disclosure of the nature and scope
of the consumer report or investigative consumer report ordered by the Company. ADP SASS can be reached at: 2950 East Harmony Road, Suite 130, Fort Collins, CO, 80528 (telephone)
800-367-5933; or www.adpselect.com.

NEW JERSEY: If you submit a request to the Company in writing, you have the right to know whether the Company ordered an investigative consumer report from ADP Screening and Selection
Services, Inc. (ADP SASS). An investigative consumer report may contain the following information pertaining to you, as applicable: credit history; public records; a Social Security number
verification; driving records; military service; credentials/certifications; and verification of prior employment and education. You may inspect and order a free copy of the report by contacting
ADP SASS at: 2950 East Harmony Road, Suite 130, Fort Collins, CO, 80528; (telephone) 800-367-5933; or www.adpselect.com.

NEW YORK: If you submit a request to the Company in writing, you have the right to know whether the Company ordered a consumer report or an investigative consumer report from ADP
Screening and Selection Services, Inc. (ADP SASS) that may contain the following information pertaining to you: credit history; public records; a Social Security number verification; driving
records; military service; credentials/certifications; and verification of prior employment and education. You may inspect and order a free copy of the report(s) by contacting ADP SASS. By
signing the separate document called the Authorization for Background Checks, you agree that you have received a copy of Article 23A of the New York Correction Law (provided with this
document).

Reviewed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
Authorization for Background Check
AUTHORIZATION FOR BACKGROUND CHECKS

I instruct and authorize 24 Hour Fitness USA, LLC (the "Company") to obtain a consumer report(s) (or background check report(s)) on me, including any investigative consumer reports and any
consumer credit reports.* I also agree that a copy of this form is valid like the signed original.

The consumer reporting agency (CRA) ADP Screening and Selection Services, Inc. (ADP SASS) will conduct the background check and prepare the background check report for the Company. ADP
SASS is located at 2950 East Harmony Road, Suite 130, Fort Collins, CO, 80528, and can be reached by phone at 800-367-5933, or at www.adpselect.com.

I understand that, as allowed by applicable law, the Company may rely on this authorization to order additional background check reports, including investigative consumer reports and any
consumer credit reports* (1) during my employment or time as a volunteer or independent contractor, as applicable, and (2) from any CRA other than ADP SASS without asking me for my
authorization again. I understand the Company may order background check report(s) under my legal name and any other names I may have used.

I also instruct and authorize the following persons, agencies, and entities to disclose to ADP SASS and its agents all information about or concerning me, as allowed by law, including but not
limited to: my past or present employers; learning institutions, including colleges and universities; law enforcement and all other federal, state and local agencies; federal, state and local courts;
the military; credit bureaus; testing facilities; motor vehicle records agencies; all other private and public sector repositories of information; and any other person, organization, or agency with
any information about or concerning me. As allowed by law, such disclosures may contain the following information pertaining to me: credit history*; public records; a Social Security number
verification; driving records; military service; credentials/certifications; worker's compensation injuries; and verification of prior employment and education.

● I understand that I am instructing and authorizing the Company to obtain a consumer credit report only to the extent permitted by law. If I reside or anticipate being employed in New York City, I
understand that I am not being asked to authorize a consumer credit report by signing this document.

By signing below, I understand that I am agreeing to the terms contained in this document.

If you live or work for the Company in California, Minnesota or Oklahoma:

No
Select Yes if you would like a free copy of background check report:

Legal First Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hector

Legal Last Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mendoza
Do you have a Middle Name? . Yes
.....................................................
Legal Middle Name** . David
.....................................................
Name Suffix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Signature

To electronically sign the Background Authorization form please enter your full legal name and select "Accept".
I authorize my Electronic Signature . Hector Mendoza
..................................................... Accepted
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Feb 29, 2024 03:57 pm
(System will autofill)
Background Check Information
BACKGROUND CHECK INFORMATION

The information requested below is collected for the purpose of aiding the Company in running a background check in connection with your employment or application for employment. The
information you provide may be used for other employment or hiring purposes.

** = Conditionally Required Field

Legal First Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hector
Legal Middle Name . David
.....................................................
Legal Last Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mendoza
Legal Suffix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 08/16/1970
Social Security Number . 562-82-9371
.....................................................
Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hispanic or Latino
Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Male
Do you have a valid driver's license? .
..................................................... No
(Some positions may require that you have a license)
Driver's License Number** . 2569426
.....................................................
Expiration Date** . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03/30/2024
Issued State** . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Oregon
Previous Address

Addresses Within The Past Seven Years

Present Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7025 se clackamas rd
Address 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . United States
City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Milwaukee
State/Province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Oregon
(Required only for United States or Canada)
Zip/Postal Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97267

Previous Address 1
Previous Street Address .
.....................................................
Previous Address 2 .
.....................................................
Country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
State/Province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Zip/Postal Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
From . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
To . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other Names Used

Enter Any Other Names Used (including maiden names and nicknames)

Other Names Used 1

First Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Middle Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .