Background Check Authorization Form

Information you will need

• Who's ordering the background check?
• Who's conducting the background check?
• What's the background check company's address?
• What's the background check company's phone number?
• What's the applicant's first name?
• What's the applicant's middle name?
• What's the applicant's last name?
• What's the applicant's date of birth?
• What's the applicant's SSN?
• What's the applicant's driver's license number?
• What state issued the driver's license?
• What's the applicant's phone number?
• What's the applicant's email?
• What's the applicant's prior first name?
• What's the applicant's prior middle name?
• What's the applicant's prior last name?
• What's the applicant's second prior first name?
• What's the applicant's second prior middle name?
• What's the applicant's second prior last name?
• What's the applicant's third prior first name?
• What's the applicant's third prior middle name?
• What's the applicant's third prior last name?
• What's the applicant's current address?
• What's the applicant's prior address?

…and 10 more fields in the PDF.

Completed by the employer.

The form includes 1 signature line.