Background Check Release Form

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**