BACKGROUND CHECK DISCLOSURE AND AUTHORIZATION FORM
In the interest of maintaining the safety and security of our customers, employees and property,
___________________________ (the “Company”) will order a “consumer report” (a background report) or “investigative consumer
report" on you in connection with your employment application, and if you are hired, or if you already work for the Company, may order
additional background reports on you for employment purposes.
The background check company, _________________________________ (the "Background Check Company"), will prepare the
background report for the Company. The Background Check Company is located at ___________________________, and can be
reached by phone at ____________________ or at their Internet Web site address _____________________________.
The background report may contain information concerning your character, general reputation, personal characteristics, mode of living,
and credit standing. The types of information that ma