Background Check Authorization

Purpose: This document serves as a formal authorization for employers to perform background checks on an individual being considered for employment. The information obtained through these checks will be used solely for employment-related decisions and in accordance with applicable laws.

Candidate Information

Full Name: {fullName}
Date of Birth: {dateOfBirth}
Social Security Number (Last 4 digits): {ssnLast4}
Address: {address}
Phone Number: {phoneNumber}
Email: {email}

Employer Information

Company Name: {companyName}
Contact Person: {employerContact}
Contact Phone: {employerPhone}
Position Applied For: {positionApplied}

Consent and Authorization

I, {fullName}, hereby authorize {companyName} to obtain information regarding my background, including but not limited to:

{#backgroundChecks}

• {checkType}

{/backgroundChecks}

This information may be obtained from government agencies, current and previous employers, educational institutions, and other relevant sources, and may include records such as criminal history, credit history, employment history, and educational verification.

I understand that I have the right to request a copy of the report obtained and that I have the right to dispute any inaccurate or incomplete information.

This authorization shall remain in effect during the application process and, if hired, throughout the duration of my employment, unless revoked in writing.

Signature

Printed Name: {fullName}
Signature: ___________________________
Date: {dateSigned}

Optional Notes

{^hasNotes}No additional notes provided.{/hasNotes}

{#hasNotes}Notes: {notes}{/hasNotes}