Sample State-Required Consumer Disclosures

These sample documents should not be construed as legal advice, guidance or counsel. Employers should consult their own attorneys regarding their compliance obligations under the FCRA and applicable State Laws. DISA expressly disclaims any warranties associated or arising out of information or example documentation provided.


This resource library contains seven sample state-required consumer disclosures: California, New York, Vermont, Washington, New Jersey, Minnesota, and Oklahoma. If your applicant or employee resides or works in one or more of these states, you may be required by the laws of those states to provide notices to those applicants/employees in connection with obtaining a consumer report from GHRR. These state-related forms are provided for your education and consideration only; as always, you will want to consult with your compliance officer or legal counsel regarding the content of and obligation to use state-related forms.


Please Note: Some of the state-related forms provide the applicant and/or employee with the opportunity to request a copy of his consumer report. If the applicant/employee makes such a request by check marking the appropriate box, please let us know by sending an email to screening.support@disa.com with a request that we provide the applicant/employee with a copy of the consumer report.

Sample California Disclosure - Investigative Consumer Reports

Sample California Disclosure - Credit Reports

Sample Minnesota Disclosure

Sample New Jersey Disclosure

Sample New York Disclosure

Sample Oklahoma Disclosure

Sample Vermont Disclosure

Sample Washington Disclosure