Background Check Release Form

Kathy Bentz

November 07, 2018

As part of your qualification process for new employees, you may want to conduct a background check. Use this form to secure their permission. You can download in MS Word for a printable copy.

CONSUMER CREDIT and BACKGROUND REPORT RELEASE FORM

PLEASE READ CAREFULLY

BY MY SIGNATURE BELOW I AUTHORIZE

____________________________________________________ to obtain a Consumer Credit Report and/or a Background Report on me. This authorization is valid for purposes of verifying information given pursuant to employment, leasing, rental, business negotiations, or any other lawful purpose covered under the Fair Credit Reporting Act. (FCRA)

The Background Check may contain information available in the Public Doman but may not include interviews with persons other than previous employers or their agents.

By my signature below, I hereby authorize all corporations, former employers, credit agencies, educational institutions, law enforcement agencies, city, state, county and federal courts and agencies, military services and persons to release all information they may have about me including criminal and driving history. Their authorization shall be valid in original or copy form.

Applicant’s Name _____________________________________________________

Social Security Number _________________________________________________

Date of Birth ________________________________________________________

Current Street Address _________________________________________________

City, State, Zip Code ___________________________________________________

Drivers License Number ____________________________________ State ________

Signature __________________________________________________________

Date _______________________

**NOTE: PLEASE INCLUDE A COPY OF A VALID DRIVERS LICENSE**