In a separate Word or text document, please provide a response to the following. When complete, upload your document.
- Why are you interested in serving as a director of the Cooperative?
- What qualifications do you have that you feel would be beneficial to the Cooperative and to you in serving as a director?
- State your understanding of the time commitment requirements for a director of the Cooperative, both in terms of attendance at monthly meetings and in terms of other meetings. Are you able and willing to make the time commitment required? Please state any possible conflicts you foresee if elected as a director in being able to spend the time required.
- What do you see as the major challenges the Cooperative will face within the next five years?
- A copy of the Cooperative’s Conflict of Interest policy is attached. Are you willing and able to adhere to the provisions of the policy? If not, why not?
BACKGROUND CHECK DISCLOSURE AND AUTHORIZATION
Board of Director Candidate – First Electric Cooperative Corporation
Instructions to Candidate:
Please read carefully. Section 1 is a standalone disclosure under the Fair Credit Reporting Act (FCRA). Section 2 authorizes background screenings and related checks, which are performed by our third party vendor pursuant to your consent. The background screening and related checks do not include a “consumer report” (credit report) or any drug screening. Please sign the below acknowledgment where indicated.
SECTION 1.
FECC may obtain one or more investigative consumer reports about you for purposes related to your candidacy for election or appointment to FECC’s Board of Directors. These reports may be prepared by or with information from a consumer reporting agency and may include information about your character, general reputation, personal characteristics, and mode of living.
The reports FECC may obtain can include, as applicable:
- Criminal history records (federal, state, and local) and searches of state and national criminal databases and registries.
- Governmental watch list, sanction list, and exclusion list checks.
- Motor vehicle and driving records.
- Identity verification, address history, and prior names/aliases.
- Education, employment, and reference verification.
- Publicly available information from courts and government records.
- Publicly available online and social media information.
You have the right to request, in writing, a complete and accurate disclosure of the nature and scope of any investigative consumer report requested, and to receive a copy of the “A Summary of Your Rights Under the Fair Credit Reporting Act.”
SECTION 2. AUTHORIZATION AND CANDIDATE CONSENTS.
By signing below, I voluntarily and knowingly authorize the following, subject to and consistent with applicable federal, state, and local law:
2.1 Authorization. I authorize FECC and its designated agents, including any consumer reporting agency, to obtain the information about me, including in any investigative consumer reports, at any time in connection with my candidacy for the Board of Directors, and, if I become a director, to the extent reasonably necessary for continued service or role-related determinations. I understand that this authorization does not authorize FECC or its designated agents to obtain any consumer report (credit report).
2.2 Criminal History, National Database, and Identity/Address Searches. I authorize searches of federal, state, and local criminal history records; national or multijurisdictional criminal databases; sex offender registries; sanctions/watchlists; and identity, address, and alias history.
2.3 Motor Vehicle Record (MVR)/Driving Record—DPPA Consent. Where relevant to the role or FECC risk management, I authorize FECC and its designated agents to obtain my motor vehicle and driving records from any state, including Arkansas. This consent is provided pursuant to the federal Driver’s Privacy Protection Act (DPPA) and applicable state law.
2.4 Education, Employment and Reverence Verification. I authorize FECC and its designated agents to verify my education, employment and references.
2.5 Public Social Media and Online Searches. I authorize FECC and its agents to review publicly available online and social media content for candidacy-related purposes. I understand I will not be asked to disclose usernames, passwords, or the content of nonpublic communications, nor to add FECC or its agents to my private networks.
2.6 FECC Service Account Review. I authorize FECC to review and provide to its Nominating Committee my service/account information with FECC, if any and to the extent relevant to my candidacy. This may include my current and past service addresses, length of service at each location, usage records, other/previous accounts, payment history, past disputes, and correspondence.
2.7 Disclosures, Adverse Action. Before FECC takes any action adverse to my continued service or role-related determinations that is based in whole or in part on a consumer report, FECC will provide me with a copy of the report, a summary of my rights under the FCRA, and I will be given a reasonable opportunity to respond, as required by law.
2.8 Further Consents or Authorizations. If additional, further, or duplicate consents or authorizations are required from me in order to carry out an act I have authorized herein, I agree to executing same, and to do so in a timely manner.
2.9 Ongoing Nature of Authorization. This authorization remains valid through the candidacy process and, if I become a director, during my service as a director, and permits FECC to obtain updated reports of the same types and categories of information authorized herein when reasonably necessary for legitimate, role related purposes and as permitted by law. I may revoke this authorization prospectively at any time by written notice, which will not affect reports already obtained or actions already taken.
2.10 Accuracy, Use, and Nondiscrimination. I understand FECC will not use any report or information in violation of applicable federal, state, or local equal employment, fair credit or other relevant laws, and will consider the nature, gravity, recency, and relevance of any information as they relate to legitimate FECC interests and role-related criteria. I acknowledge my right to dispute inaccurate or incomplete information with the consumer reporting agency.
2.11 Limited Release. To the fullest extent permitted by law, I release FECC, its directors, officers, employees, agents, and any reporting agency, consumer reporting agency, or information provider from liability for collecting, providing, and using information obtained in good faith pursuant to any authorization executed pursuant to this Notification, except that this release does not waive any rights I have under the FCRA or other non-waivable applicable laws.
SECTION 3. CANDIDATE DISCLOSURES AND CERTIFICATIONS
- I certify that the information I provide to FECC or its agents in connection with my background checks, including in any authorization or consent executed pursuant to same, is true, correct, and complete to the best of my knowledge.
- I understand that any material misrepresentation or omission may adversely affect my candidacy or, if applicable, my service as a director, consistent with applicable law.
SECTION 4. CANDIDATE SIGNATURE.
By signing below, I acknowledge receipt of the FCRA Standalone Disclosure in Section 1 and provide the Authorization and Consents in Section 2. I also make the certifications in Section 3.