Texas A&M International University Background Check Authorization Form - DPS Form 3 - 11/14

Sep 17, 2026

Uploaded by Pentious

Texas A&M International University background check authorization form collects applicant or employee information to support employment eligibility decisions. The hiring department completes job vacancy and position details, while the applicant provides identifying data, addresses, and consent to release criminal history records. Applicants answer questions about prior convictions, deferred adjudication, pretrial diversion, probation or community supervision, and pending charges. It also includes notice about Texas Department of Public Safety computerized criminal history verification and requirements related to reporting arrests, charges, or convictions.

LanguageEnglish

CategoryForms

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

Background Check Authorization Form

To Be Completed by the Hiring Department

To Be Completed and Signed by the Applicant/Employee

Authorization and Release of Information

Certification and Reporting Requirements

DPS Computerized Criminal History (CCH) Verification (Agency Copy)

| Texas A&M International University Background Check Authorization Form
With few exceptions, you have the right to request, receive, review, and correct information about yourself using this form. |
A Member of the Texas A&M University System | | --- | --- | | An Equal Opportunity/Affirmative Action/Veterans/Disability Employer: Texas A&M International University does not discriminate on any basis prohibited by applicable law including race, color, religion, sex, national origin, disability, age, citizenship status, or veteran status in recruitment, employment, promotion, compensation, benefits, or training. The information on this form is the property of Texas A&M International University. | | The following is to be completed by the hiring department: Job Vacancy Number: Title of Position: Department: Requested by: Department Paying Account to be Charged (investigation involves a minimal fee of approximately $5): The following is to be completed and signed by the applicant/employee: Please legibly print all information requested. Last Name: FirstName: Middle Initial: SSN: Please indicate other name(s) used in any and all other records of birth or records of residence. Present Address (number and street) City State Zip Code Race: Sex: DOB (mo/day/yr): Driver’s License \#: State Issuing Driver’s License: The following are my responses to questions about my criminal history, if any (excluding minor traffic offenses). Circle Yes or No. 1. Have you ever been convicted or pled guilty before a court for any federal, state, or municipal criminal offense? Yes No 2. Have you ever received deferred adjudication or similar dispositionfor any federal, state, or municipal offense? Yes No 3. Have you ever received pretrial diversion or similar dispositionfor any federal, state, or municipal offense? Yes No 4. Have you ever received probation or community supervisionfor any federal, state, or municipal offense? Yes No 5. Have you been convicted of any criminal offense in a country outside the jurisdiction of the United States? Yes No 6. As of the date of this consent form, do you have anypending charges against you? Yes No If you answered Yes to any of the questions above, please provide details below. Attach extra pages if needed. State: County: Date of Offense (mo/day/yr): Details of Offense: State: County: Date of Offense (mo/day/yr): Details of Offense: Please list all places of residence since the age of 18. Include city, state, county, and country. Attach extra pages if needed. _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ I hereby authorize Texas A&M International University (TAMIU) to obtain my criminal history record. TAMIU may obtain my background information, including criminal history record, Selective Service registration, and degree verification at any time during my application process and/or employment. I understand this information will be used for the purpose of determining my eligibility for employment or continued employment with TAMIU. I hereby authorize the Texas Department of Public Safety or any other entity authorized to access state or federal agency records to furnish TAMIU, or its agent, my criminal history record. I do hereby release all agents, servants, and employees of TAMIU; the person in charge of any law enforcement agency or department; and all members of such law enforcement agency or department from all liability resulting from the release of this information. I acknowledge that a facsimile or copy of this document shall have the same validity, force and effect as the original. System Regulation 33.99.14 addresses the operation of criminal history investigations within the A&M System, including appeal procedures, and requires that withi

FAQs

What information must the hiring department complete on this form?

The hiring department provides the job vacancy number, position title, department, requester, and the department paying account to be charged.

What criminal history questions does the applicant answer?

The applicant indicates whether they have been convicted or pled guilty, received deferred adjudication, pretrial diversion, probation or community supervision, convictions outside the U.S., and whether there are any pending charges.

How does the DPS computerized criminal history (CCH) verification work?

Verification is performed by accessing the Texas DPS secure website using name and DOB identifiers supplied by the applicant, and fingerprint searches may be requested to correct potential misidentification.

Sep 17, 2026

Uploaded by Pentious