Employment Background Check Authorization Form

Pre-Employment Criminal Record Background Check Authorization Form

Even though many criminal records are public records, an employer must first obtain written authorization on any potential employee prior to conducting a criminal record employment background check.
The release should not only give the employer the authorization to conduct a criminal record background check but should also contain language releasing or holding the employer harmless for the background check process.

One of the most important compliance aspects of obtaining the applicant's permission to conduct a pre-employment background check, is that the release must be on a form or sheet of paper that is entirely separate from any other document.

The information needed to do a criminal record background check:

1. Applicant's First and last name

2. Applicant's Date Of Birth
(Criminal records are filed and verified by name and date of birth)

3. Applicant's 7 year address history

4.  Applicant's drivers license number and issuing state if requesting a driving record report.

5. Applicant's Social Security number.

A number of states also impose other notice requirements on the handling of employment background checks.

The States of CaliforniaMinnesota or Oklahoma the applicant must be notified that they are entitled to a free copy of their background check.

See New York correction Law Article 23.-A, regarding licensure and employment of persons previously convicted of one or more criminal offenses.

California Civil Code 1786.22 requires applicants be given A Summary of Your Rights.

The link to the page from our website:

“BACKGROUND CHECKS – WHAT EMPLOYERS NEED TO KNOW” contains much useful information that employers need to comply with Federal employment screening law.

"Free " Background checks are regarded as possibly dangerous by many employers as they miss so many criminal records they are virtually worthless.

Remember the trust placed in an employee or anyone else due to relying on the results of a criminal record background check.

For the cost of a copy machine ink cartridge, you can obtain a valuable criminal record background check conducted by a professional employment screening company.



 To: Any person having knowledge of my conduct or activities, or any past, present or future Employer, Credit Bureau, Bank, Financial Institution, Dean, Registrar, Principal, Counselor, Instructor, or School, Law Enforcement Agency, Government Agency or Armed Forces:

I, ___________________________________ hereby authorize National Employment Screening through its agents, to conduct an appropriate background investigation of me and prepare a consumer report or investigative consumer report which may be used as a factor in determining my eligibility for employment, promotion or retention as governed by the Fair Credit Reporting Act Public Law 91-508. I understand this report may include information from personal interviews about my character, general reputation, personal characteristics and mode of living as well as public and private sources including but not limited to the acquisition of criminal records, employment records, school records, driving records or abstracts, etc. I further understand the information contained in my credit report may be used as a factor in any employment decision. I authorize all persons who may have information relevant to this investigation to disclose it to NATIONAL EMPLOYMENT SCREENING and its agents, and I release all persons from any liability on account of such disclosure. I hereby further authorize that a photocopy of this authorization may be considered as valid as an original.

Signature: _____________________________________ Date: ___


Furnished for the purpose of positive identification: (Print Clearly)

Last: ____________________________________ First: ____________________________________ MI: _____

Address: _________________________________________   City: ____________ State: ________ Zip: __________

A.K.A. (include maiden name): _________________________________________

SSN: _________-_______-_________ DOB: _____/_____/______

Driver License #: _________________________________________________ State: ___

Address History (Past 7 Years)














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None of the information contained in this web site should be construed as legal advice.
All forms, policies, information and procedures should be reviewed by your legal counsel before being used in any way.

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