Request a Copy of Your Current Xchange Network Verification Information
Please complete the form below to request a copy of your current Xchange Network Verification
Information. In order to process your request quickly, please provide all information requested and
closely review all instructions. This information is solely to confirm your identity and will remain
confidential.
By completing this form, you will be submitting a request to SPEC Building Materials for a copy of the DOT- required
verification information that carriers have provided over the Xchange Network to carriers you've
applied
to that requested the verification information. SPEC Building Materials will also provide you with an activity
report
showing the list of carriers that have provided and received any DOT-required verification information
about you through the Xchange Network.
If you need further assistance or would like to request your Xchange Network Verification Information
by
telephone, fax, or regular mail please contact:
Spec Building Material Corporation Telephone: 1-202-239-specbm, Option 1, then 1
Email: info@specbmsupply.com Address: 2840 Roe Lane
Kansas City, KS 66103
Dispute Information on a Verification Completed Through SPEC Building Materials's Xchange
Network If you wish to dispute any information provided on a verification completed through SPEC Building Materials's
Xchange Network, we recommend you first obtain a copy of the information by completing the form below
so
that you have specific details in order to communicate your dispute to SPEC Building Materials's Consumer Service
department. After reviewing the information, if you believe the information in the verification is
inaccurate or incomplete, please email details regarding your dispute to SPEC Building Materials's Consumer Service
department at info@specbmsupply.com. You may also contact a
Consumer representative at 1-202-239-specbm, Option 1, then 1 or submit your dispute by regular mail to
the address listed above.
Personal Information
Completion Progress
Completion Progress
Confirmation
Please verify that all of the information below is correct: (You may need to scroll down to the bottom to continue
)
Personal Information
Name
Jace Emma Alex, Jr.
Current Address
No 14 Brooklyn
City, State/Province Zip/Postal
New York, NY 40001
Country
United States
Residence 3 years or longer (If No, previous addresses shown below)
By clicking next, I agree that my electronic signature will be applied to my
application. An electronic signature is as legally binding as an ink signature.
This certifies that this application was completed by me, and that all entries
on it and information in it are true and complete to the best of my knowledge.
Completion Progress
Completion Progress
A Summary of Your Rights Under the Fair Credit Reporting Act
Para información en español, 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
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 form 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:
TYPE OF BUSINESS:
CONTACT:
1.a. Banks, savings associations, and credit unions with total assets of over
$10 billion and their affiliates
b. Such affiliates that are not banks, savings associations, or credit unions
also should list, in addition to the CFPB:
a. Consumer Financial Protection Bureau
1700 G Street, NW
Washington, DC 20552
b. Federal Trade Commission
Consumer Response Center
600 Pennsylvania Avenue NW
Washington, DC 20580
(877) 382-4357
2. To the extent not included in item 1 above:
a. National banks, federal savings associations, and federal branches and
federal agencies of foreign banks
b. State member banks, branches and agencies of foreign banks (other than
federal branches, federal agencies, and Insured State Branches of Foreign
Banks), commercial lending companies owned or controlled by foreign banks, and
organizations operating under section 25 or 25A of the Federal Reserve
Act.
c. Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured
state savings associations
d. Federal Credit Unions
a. Office of the Comptroller of the Currency
Customer Assistance Group
P.O. Box 53570
Houston, TX 77052
b. Federal Reserve Consumer Help Center
P.O. Box 1200
Minneapolis, MN 55480
c. Division of Depositor and Consumer Protection
National Center for Consumer and Depositor Assistance
Federal Deposit Insurance Corporation
1100 Walnut Street, Box #11
Kansas City, MO 64106
d. National Credit Union Administration
Office of Consumer Financial Protection
1775 Duke Street
Alexandria, VA 22314
3. Air Carriers
Assistant General Counsel for Office of Aviation Consumer Protection
Department of Transportation
1200 New Jersey Avenue, SE
Washington, DC 20590
4. Creditors Subject to the Surface Transportation Board
Office of Public Assistance, Governmental Affairs, and Compliance
Surface Transportation Board
395 E Street SW
Washington, DC 20423
5. Creditors Subject to the Packers and Stockyards Act, 1921
Nearest Packers and Stockyards Division Regional Office
6. Small Business Investment Companies
Associate Administrator, Office of Capital Access
United States Small Business Administration
409 Third Street SW, Suite 8200
Washington, DC 20416
7. Brokers and Dealers
Securities and Exchange Commission
100 F Street NE
Washington, DC 20549
8. Institutions that are members of the Farm Credit System
Farm Credit Administration
1501 Farm Credit Drive
McLean, VA 22102-5090
9. Retailers, Finance Companies, and All Other Creditors Not
Listed Above
Federal Trade Commission
Consumer Response Center
600 Pennsylvania Avenue NW
Washington, DC 20580
(877) 382-4357
(NEW YORK APPLICANTS ONLY) ARTICLE 23-A, NEW YORK STATE
CORRECTION LAW
§ 750. Definitions. For the purposes of this article, the
following terms shall have the following meanings:
"Public agency" means the state or any local subdivision thereof, or any
state or local department, agency, board or commission.
"Private employer" means any person, company, corporation, labor
organization or association which employs ten or more persons.
"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.
"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.
"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:
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
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.
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:
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.
The specific duties and responsibilities necessarily related to the
license or employment sought or held by the person.
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.
The time which has elapsed since the occurrence of the criminal
offense or offenses.
The age of the person at the time of occurrence of the criminal
offense or offenses.
The seriousness of the offense or offenses.
Any information produced by the person, or produced on his behalf, in
regard to his rehabilitation and good conduct.
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.
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.
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.
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.
The Fair Credit Reporting Act provides criminal and civil penalties for persons improperly
obtaining consumer report information from consumer reporting agencies.
Pursuant to the Fair Credit Reporting Act and other applicable laws, I authorize SPEC Building Materials
LLC to provide me with the information it currently possesses pertaining
to me as specifically designated in this Form. By submitting this Form, I certify to
SPEC Building Materials that: (i) I am the consumer identified in this Form; (ii) all information
provided
herein is complete and accurate; (iii) prior to signing this Form I was given an
opportunity to ask questions and to have those questions answered to my satisfaction;
and (iv) I understand I may be subject to criminal and civil fines and penalties if any of
the information provided herein is false or misleading.
In accordance with DOT Regulation 49 CFR Part 391.23, I authorize the release of
information from my DOT regulated drug and alcohol
testing records by the carriers (company/school) listed above to SPEC Building Materials, for the sole
purpose
of transmitting such records to SPEC Building Materials. I authorize release of the following
information concerning DOT drug and alcohol testing violations including pre-employment
tests during
the past three years: (i) alcohol tests with a result of 0.04 or higher; (ii) verified
positive drug tests;
(iii) refusals to be tested (including verified adulterated or substituted results);
(iv) other violations of DOT
drug and alcohol testing regulations; (v) information obtained from previous employers
of a drug and
alcohol rule violation(s); and (vi) documents, if any, of completion of a return-to-duty
process following
a rule violation. I also authorize the carriers (company/school) listed above to release
information about
names and dates of previous employers, reasons for termination of employment, work
experience,
accidents, academic history, professional credentials and other information.
The information that I have authorized SPEC Building Materials to review involves tests required by
DOT. If any
carrier (company/school) listed above furnishes SPEC Building Materials with information concerning
items (i) through
(vi) above, I also authorize that carrier (company/school) to release and furnish the
dates of my negative
drug and/or alcohol tests and/or tests with results below 0.04 during the three-year
period and the name
and phone number of any substance abuse professional who evaluated me during the past
three years.