Background Check Form
In connection with this application for employment, l understand that an investigative consumer report maybe requested
now by True Hire, and in the future as terms of my continued employment. This report may include information pertaining
to my character, education, work history, credit history, motor vehicle records, and criminal information contained within any government agency, Federal, State, or Local. This information shall include, but not be limited to, verifying any statements made on my application.

I hereby authorize all corporations, companies, credit agencies, educational institutions, persons, law enforcement agencies, military services, and former employers to release information they may have about me to Company or its agents, and do forever release them from any liability or responsibility for doing so to the fullest extent allowed by law from any claims arising from the requested information.

If required, I specifically authorize a credit report to be obtained on myself. If required, l specifically authorize workers compensation claim information to be obtained on myself by True Hire.

I recognize and agree that a copy or facsimile of this document shall be as valid as the original and agree that this release shall be valid for this and any future update reports requested.

Confidential Information Used for Background Checking Purposes

First, Middle, and Last Name *
Your answer
Social Security Number (or personal identifier) *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Driver's License Number/State of Issuance *
Your answer
Present Address (street, city, state, county) *
Your answer
Phone number
Your answer
Email Address
Your answer
List any previous addresses you have had in the past 7 years
Your answer
List any former names you have used in the past 7 years.
Your answer
List any felonies or misdemeanors you have been convicted of in the past 7 years.
Your answer
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