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Background Check Form 05

This document is a consent form for a background check. It allows an organization to obtain an applicant's personal information including criminal records, sex offender registry checks, address history, and social security verification from various sources. The applicant signs to authorize the background check and any subsequent checks during their volunteer/employment period, and releases all parties providing information from liability.

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Richard Blanc
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1K views1 page

Background Check Form 05

This document is a consent form for a background check. It allows an organization to obtain an applicant's personal information including criminal records, sex offender registry checks, address history, and social security verification from various sources. The applicant signs to authorize the background check and any subsequent checks during their volunteer/employment period, and releases all parties providing information from liability.

Uploaded by

Richard Blanc
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Background Check Consent and Release Waiver

National Background Screening Consent Form

Applicant’s Legal Name (printed)

Social Security Number Date of Birth

Applicant’s Address

City State Zip

I, , authorize and give consent for the above


named organization to obtain information regarding myself. This includes the following:

 Local & National Criminal background records/information


 All 50 State Sex Offender Registries
 Full Address Trace
 Social Security Verification

I, the undersigned, authorize this information to be obtained either in writing or via


telephone in connection with my application. Any person, firm or organization providing
information or records in accordance with this authorization is released from any and
all claims of liability for compliance. Such information will be held in confidence in
accordance with the organization’s guidelines.

By signing this document, I am providing the above named Organization my consent


for an initial background check as well as any subsequent background checks deemed
necessary throughout the length of my volunteer/employment assignment with this
Organization.

Print Name: Date:

Signature:

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