Background Check Notification and Authorization

The following document contains three examples of notice and authorization forms for use in checking candidate backgrounds.

–        Consent to procure a consumer credit report

–        Driving Check Request

–        Pre-Employment Inquiry Authorization Release

CONSENT FOR PROCUREMENT OF CONSUMER CREDIT REPORT

I understand that, as a condition of my consideration for employment with XXX, or as a condition of my continued employment with XXX, XXX may obtain a consumer report that includes, but is not limited to, my creditworthiness or similar characteristics, employment and education verifications, social security verification, criminal and civil history, personal interviews, DMV records, any other public records and any other information bearing on my credit standing, credit capacity, character, general reputation, personal characteristics and trustworthiness.

I hereby authorize and consent to XXX procurement of such a report. I understand that, pursuant to the federal Fair Credit Reporting Act, XXX will provide me with a copy of any such report if the information contained in such report is, in any way, to be used in making a decision regarding my fitness for employment with XXX. I further understand that such report will be made available to me prior to any such decision being made, along with the name and address of the reporting agency that produced the report.

 

________________________________________     _____/_____/_____

Signature of Applicant or Employee                       Date

 

________________________________________

Printed Name of Applicant or Employee

DRIVING CHECK REQUEST AND RELEASE FROM LIABILITY

The position I am applying for is a __________________Driving position.

I understand that driving a XXX vehicle (or my own vehicle, as required) is a requirement of the position I am being considered for and that having and maintaining a satisfactory driving record is a condition of my employment. I agree to allow the XXX to check my driving record prior to hire and to check it periodically thereafter. I further agree to report any license suspensions, serious accidents or offenses, or any other condition to my supervisor immediately that may affect my ability to drive a XXX vehicle (or my own vehicle, if I am required to drive) after I am hired. I agree to obtain a Driver’s license prior to hire if I do not already have one.

I understand that the XXX will use this information for employment purposes only and not furnish this information to a third party without my written consent.

I agree to release XXX, its employees and those who supplied you with the information from any liability for any damage, which may result from furnishing the requested information or my failure to be hired for the position for which I am applying.

 

________________________________________

Print Name

________________________________________

Driver’s License Number

________________________________________

Signature

_______________

Date of Birth

_______________

State of License

_______________

Date

PRE-EMPLOYMENT INQUIRY AUTHORIZATION RELEASE

In connection with my application for employment, I understand and agree that background inquires may be requested by you or on your behalf that will seek information as to my character, work habits, including oral assessments of my job performance, experiences and abilities, along with reasons for termination of past employment. Furthermore, I understand and agree that you may request information from various federal, state, and other agencies, including public and private sources which maintain records concerning my past activities relating to my driving record, credit history, criminal record, civil matters, previous employment, educational background, and other past experiences.

I acknowledge that a telephonic facsimile or copy of this release shall be as valid as the original. This release is valid for all federal, state, county and local agencies and authorities.

The following is my complete and legal name, and all information is true and correct to the best of my knowledge.

 

Last Name		First				Middle
Applicant’s Signature		Driver’s License Number & State
Social Security Number			Response to the questions in this section are optional and voluntary, for ID only Date of Birth: ___/___/___ Race: _______________ Sex: M __ F __
Former Names and time frames (if applicable)
Current Address	City/State			Zip & County	Dates(Month and Year)
Previous

___________________________________________     _____/_____/_____

Signature of Applicant or Employee                                                             Date

______________________________________________________