Free background check form 14
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CONFIDENTIAL

Background Check Authorization
Print Name:
(First)

(Middle)

(Last)

Former Name(s) and Dates Used:
Current Address Since:
(Mo/Yr) (Street)

(City)

(Zip/State)

(Mo/Yr) (Street)

(City)

(Zip/State)

(Mo/Yr) (Street)

(City)

(Zip/State)

Previous Address From:
Previous Address From:

Social Security Number:
DOB:
Telephone Number:
Drivers License Number/State:

The information contained in this application is correct to the best of my knowledge.
I hereby authorize
and its designated agents and
representatives to conduct a comprehensive review of my background causing a consumer report
and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I
understand that the scope of the consumer report/ investigative consumer report may include, but is not
limited to the following areas: verification of social security number; credit reports, current and previous
residences; employment history, education background, character references; dru