3 minutes
The background verification consent form can be filled by any individual who wishes to conduct a background check on another individual.
Full Name
Date of Birth
Social Security number
Current residential address
Phone number
Email address
Current employment status
How many years of professional work experience do you have?
Please list all previous employers, including contact information.
Have you ever been convicted of a crime?
If yes, please explain the circumstances.
Please list any relevant professional licenses or certifications.
Do you have any professional references? if yes please provide contact information.
I hereby give consent for my employer to conduct a background verification on me. I understand that this may include, but is not limited to, verification of my employment history, education, and criminal background. I release all parties from any liability that may result from the use or misuse of this information.
Signature
Date
Please upload the documents required