The following example is based on an actual report LaCosta Data Services
filed with
one of our clients. Reports can be either faxed or e-mailed.
===============================================================
LACOSTA DATA SERVICES—972 250 0592—FAX NUMBER OF PAGES—2
01/19/99
REPORT ON APPLICANT
VIA FACSIMILE TO: JOHN SMITH--MANAGER ABC
CONVENIENCE STORES
ANYTOWN, TX (999) 555-1212
APPLICANT’S NAME: John
Harold Doe SOCIAL SECURITY: 000-00-0000
TX DRIVER’S LICENSE 00000000
AVAILABLE: FULL TIME/DAY/EVENING/NIGHT
- RECENT EMPLOYMENT (LAST FOUR JOBS)
C&P Convenience Store—5/98 through 1/99—fired for being rude to customers
and several shortages in the register—usually $25 at a time, B. Grandma's Chicken
Shack—9/97 through 5/98—left for a job with better pay--no notice given, C.
Shorty's Bar and Grill—2/97 through 9/97—fired for pocketing cash payments, D.
Center City Spa—7/94 through 2/95—fired due to personality conflict with
manager.
- PERSONAL OBLIGATIONS: Applicant not sure but may have some "insufficient fund"
checks out--has not checked to find out--said he never opens any letters from
bank--quits writing checks when he thinks money is about gone. Owes money
to DEF Fiancée--about $4,000--quit making payments about one year ago.
- DRIVING RECORD: License suspended in 95 but was reinstated in 6/98. Loss of license
stemmed from wrecking auto and not carrying auto insurance.
- CRIMINAL RECORD: Agreed to plead guilty for an Indecent Exposure
arrest on 11/11/92—60 days and six months probation, Found guilty on a Public
Lewdness charge stemming from an arrest on 2/2/92—served 120 days and given a 12
month probation. Arrested in Center County in 1994 for theft by check—given a one
year probation—re arrested 10/96. Applicant stated that he has violated the terms of
his probation and is currently facing possible jail time.
- ALCOHOL/DRUGS: Consumed alcohol on the job while working as a bar back, also used and
sold illegal drugs while working as a bar back. Used cocaine regularly until eight months
ago and has been clean for two months. Currently attends Narcotics Anonymous.
- HEALTH: Good
- JOBSITE INJURIES: Pulled knee while working on job in
1988—off work six weeks.
- THEFT AND/OR CONSUMPTION OF COMPANY GOODS: Has taken small food items at different jobs.
Also applicant was fired from a job in Center City (Quickstop Store) for inventory
shortage in 1990.
- SPECIAL NOTES: A search of the Center County Civil cases showed that applicant was filed
upon on three separate occasions in 1995 for eviction from an apartment.
ANY QUESTIONS PLEASE CONTACT DIANNE ROBINSON AT 972 849 5901.
