Background Check Disclosure and Authorization Form - Authorization for Background Check

Sep 17, 2026

Upload by Angel

Background Check Disclosure and Authorization Form explains how an employer may obtain investigative consumer reports for employment purposes under the FCRA, including reference checks and verification of character, reputation, personal characteristics, criminal history, driving records, education or employment history, and related background information. It states the applicant’s right to request disclosure of the nature and scope of the investigation through the Company’s Human Resources department. The form also authorizes ongoing background screening, including future reports, and allows optional access to a free consumer copy when completed.

LanguageEnglish

CategoryForms

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

FCRA Disclosure Regarding Background Investigation for Investigative Consumer Reports

Authorization for Background Check

Consumer Copy Request

Signature Authorization

Background Check Disclosure and Authorization Form (Printed Manual Version) FCRA DISCLOSURE REGARDING BACKGROUND INVESTIGATION FOR INVESTIGATIVE CONSUMER REPORTS [Client Name](the “Company”) may obtain one or more investigative consumer reports about you from a consumer reporting agency for employment purposes. These purposes may include hiring, promotion, retention, or reassignment. These reports may include information about your character, general reputation, personal characteristics, and mode of living. They may also contain details regarding your criminal history, social security verification, motor vehicle records (“driving records”), verification of education or employment history, social media activity, or other relevant background information. You have the right, upon written request made to the Company, to receive a disclosure of the nature and scope of the investigation requested for any investigative consumer report. The most common form of such a report in connection with employment is a reference check conducted through personal interviews with sources such as former employers, associates, and other information sources. If you wish to receive a description of the scope of the investigation, please submit your written request directly to the Company’s Human Resources department. End ofFCRA DISCLOSURE REGARDING BACKGROUND INVESTIGATION FOR INVESTIGATIVE CONSUMER REPORTS AUTHORIZATION FOR BACKGROUND CHECK I acknowledge receipt of the separate document(s) entitled FCRA DISCLOSURE REGARDING BACKGROUND INVESTIGATION FOR CONSUMER REPORTS, FCRA DISCLOSURE REGARDING BACKGROUND INVESTIGATION FOR INVESTIGATIVE CONSUMER REPORTS and the disclosure entitled A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and understand that a background check will be conducted by the Company. I understand that the scope of my authorization is not limited to the present and, if I am hired, will continue throughout the duration of my employment and allow the Company to conduct future screenings for retention, promotion or reassignment, as permitted by law and unless revoked by me in writing. I hereby authorize the obtaining of investigative consumer reports by the Company at anytime after receipt of this authorization. To this end, I authorize any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by Simpliverified and/or the Company. Consumer Copy Request ☐ Check this box if you would like to receive a copy of the investigative consumer report, free of charge, once it is complete. First Name: Last Name: Birthdate: SSN: Address: City: State: Zip: Signature Authorization I certify that I have read and understand this disclosure and authorization form. I authorize the procurement of background reports by the Company. If hired, this authorization shall remain on file and shall serve as ongoing authorization for the Company to procure such reports at any time during my employment, as permitted by law. Signature Date: Printed Name: For Company Use Only: Company Representative: Date:

FAQs

What investigative consumer reports may the company obtain for employment purposes?

The company may obtain investigative consumer reports that include information about character, general reputation, personal characteristics, mode of living, and may include criminal history, Social Security verification, driving records, education/employment verification, social media activity, or other relevant background information.

How can an applicant request details about the scope of the investigation?

The applicant may submit a written request directly to the Company’s Human Resources department to receive a description of the scope of the investigation requested.

Does the authorization apply only once or also for future screenings?

The form states the authorization is not limited to the present; if hired, it continues throughout employment and allows future screenings for retention, promotion, or reassignment as permitted by law, unless revoked in writing.

Sep 17, 2026

Upload by Angel