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It covers specified categories including criminal record, sex and violent offenders, employment and education verification, license verification, motor vehicle records, personal/professional references, medical suitability, and drugs or alcohol. 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Criminal record; 6. Motor Vehicle Records;  \n2. Sex and Violent Offenders Record; 7. Personal/Professional Reference  \n3. Employment Verification; Verification;  \n4. Education Verification; 8. Medical Suitability  \n5. License Verification; 9. Drugs/Alcohol  \no I authorize all federal and state agencies, persons and organizations that may have information relevant to this research to disclose such information to Home Companion Solutions or its authorized agent(s).  \no I understand that this authorization is to be part of the written and signed employment application.  \no I also understand that I do not have to give authorization for a background check but if I don’t give permission, my employment application will not be processed further.  \no I understand that I have specific rights under the federal Fair Credit Reporting Act (FCRA) and may have additional rights under relevant State law.  \no I further authorize that a photocopy of this authorization may be considered as valid asthe original.  \no I hereby certify that all statements on this form are true and correct to the bestof my knowledge and belief.I understand that employment with Home Companion Solutions is contingent upon successful completion of a background check.  \n_________________________________ ___________  \nSignature Date  \nFull Name _____________________________ Telephone No._______________Former Name(s) and Date(s) used:_____________________________________Current Address__________________________________________________Date ofBirth________________ Social Security Number:__________________Current Driver’s License:____________________ State:___________________List any other cities, states and dates of residency during last 10 years (Use back of sheet, if necessary.)  \nCity State  \n_____________________ _______  \n_____________________ _______  \n_____________________ _______  \n_____________________ _______  \n_____________________ _______  \n_____________________ _______  \nFrom: Month/Year  \n_____________  \n_____________  \n_____________  \n_____________  \n_____________  \n_____________  \nTo: Month/Year  \n___________  \n___________  \n___________  \n___________  \n___________  \n___________  \nHuman Resources Page 1 of 1  \nEmployment Background Check Authorization","cbCailfjLXXwuooa","https://ap.wps.com/l/cbCailfjLXXwuooa","pdf",23071,"English","# Sections\n## Consent and disclosures\n## Records and verification categories\n## Signer information","[{\"question\":\"What information can be disclosed for the background check?\",\"answer\":\"The form authorizes disclosure of information relevant to the research, including criminal record, sex and violent offenders, employment and education verification, license verification, motor vehicle records, references, medical suitability, and drugs/alcohol.\"},{\"question\":\"Does the applicant have to authorize the background check?\",\"answer\":\"Authorization is optional. If permission is not given, the employment application will not be processed further.\"},{\"question\":\"What rights does the signer have under the Fair Credit Reporting Act (FCRA)?\",\"answer\":\"The signer states that they have specific rights under the federal Fair Credit Reporting Act (FCRA), and may have additional rights under applicable state law.\"}]","Pre-Employment Background Check Authorization | PDF",1789634286]