Employee Background Check Form Template

The official employee background check form enables new and prospective employees to consent to a background investigation. Employers and businesses can collect pertinent information using this form, such as contact information, maiden name, prior addresses, driver’s license information, and e-signature information.

Employee Background Check Authorization Form

Employee Information: 

Full Name: ___________________________ 

Date of Birth: ________________________ 

Social Security Number: _______________ 

Position Applied For: __________________ 

Department: _________________________ 

Start Date: _________________________

Background Check Authorization:

I, [Employee’s Full Name], hereby authorize [Your Company Name] and its designated agents to conduct a background check as part of the employment screening process. I understand that the background check may include, but is not limited to, verification of my educational qualifications, employment history, criminal record, credit history, and any other relevant information required to assess my suitability for employment.

I authorize the release of any and all information pertaining to me from schools, universities, employers, law enforcement agencies, credit bureaus, and other relevant sources that may have information concerning me. This information will be used solely for the purpose of evaluating my application for employment.

I understand that the information obtained during the background check may be used to make an employment decision, including the verification of the information provided on my application or during the interview process. I also understand that any false statements, misrepresentations, or omissions made by me may disqualify me from employment or result in termination if discovered after I am hired.

I release [Your Company Name], its employees, agents, and any third-party organizations from any liability arising from the gathering and reporting of this information.

I understand that if I am hired, this authorization will remain in effect throughout my employment, and [Your Company Name] may conduct subsequent background checks or screenings as permitted by law.

By signing below, I acknowledge that I have read and understand the information above, and I voluntarily consent to the background check described.

Signature: _________________________ Date: ___________________________

Please submit this form to the Human Resources Department or the designated personnel in charge of employee background checks.

Note: This form is a template and may need customization to align with your company’s specific requirements and legal obligations. It is always advisable to consult with legal counsel to ensure compliance with local laws and regulations.

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