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Employee Background Check Attestation

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EMPLOYEE BACKGROUND CHECK ATTESTATION

Personal Information

Date of Birth:    Last 4 of SSN:

Position Information

Anticipated Start Date:

Proposed Salary/Hourly Rate:

Background Check Consent & Scope

I hereby authorize the Company and its designated agents and representatives to obtain consumer reports and investigative consumer reports for employment purposes. These investigations may include, without limitation, criminal history records, education verifications, employment verifications, credit reports where permitted by law, motor vehicle records, and professional license verifications. I authorize all persons and institutions to release any information concerning me to the Company or its agents.

I understand that the scope, methods, and providers of any investigative or consumer report may vary. I authorize the release of information and records by educational institutions, former employers, law enforcement agencies, courts, credit bureaus, motor vehicle departments and other lawful sources. I release and hold harmless any individual, firm or corporation that furnishes such information from any liability in furnishing same.

Criminal History Disclosure

Have you ever been convicted of, or pleaded guilty or nolo contendere to, a felony or misdemeanor?      

Are there any pending criminal charges against you?      

Employment History (Most Recent First)

Title:

Dates Employed: From to

Title:

Dates Employed: From to

Education

Professional References

Legal Notices & Certifications

At-Will Employment: Nothing in this attestation or in any other communication by the Company shall be construed to create a contract of employment for any specific term. Unless otherwise expressly provided in a separate written agreement signed by an authorized representative of the Company, employment is at-will and may be terminated by either the employee or the Company at any time, with or without cause and with or without notice.

Equal Opportunity: The Company is an equal opportunity employer and does not unlawfully discriminate on the basis of protected characteristics. All background checks and employment-related decisions will be applied in a nondiscriminatory manner consistent with applicable law.

Authorization to Verify and Release Information: I authorize the Company to verify any information I have provided and to obtain any consumer or investigative reports as described above. I further authorize all persons, educational institutions, current and former employers, law enforcement agencies, courts, and other entities to release such information. I waive any right to bring a claim against the Company or any person or entity for providing or using such information in accordance with applicable law.

Use of Information for Employment Decisions: I understand that the results of background checks may affect the Company's employment decisions. I understand that, if an adverse decision is made in whole or in part because of information contained in a consumer report or investigative consumer report, I will be provided the disclosures and notices required by law prior to any final adverse action.

Additional Information

Employee Name:

Signature:

Date:

Enter text✕

What the Employee Background Check Attestation Is

The Employee Background Check Attestation is a signed statement used by employers to document an applicant’s or employee’s authorization and confirmation regarding background screening results, disclosure of prior convictions, employment eligibility, and consent to obtain consumer reports. It typically records the parties, the scope of checks (criminal, motor vehicle, credit as applicable), the date of authorization, and a signature block. Employers use this attestation to show informed consent under the Fair Credit Reporting Act and to maintain a clear audit trail for compliance, hiring decisions, and internal recordkeeping.

Why an Attestation Matters for Hiring Compliance

Use an Employee Background Check Attestation to document consent, centralize screening scope, and reduce legal exposure. A clear attestation supports FCRA compliance, creates an auditable record for HR decisions, and helps demonstrate consistent hiring practices across applicants and employees.

Why an Attestation Matters for Hiring Compliance

Who Typically Completes the Attestation

Employers, human resources, and hiring managers use this attestation during onboarding and role changes where background screening is required.

  • HR managers documenting consent and screening scope for consistent hiring decisions.
  • Compliance officers maintaining audit trails to meet FCRA and state privacy requirements.
  • Recruiters and background check vendors confirming authorized checks and disclosure acknowledgements.

Small employers and large enterprises both use attestations to standardize screening and reduce inconsistent hiring practices.

Core Elements Every Professional Attestation Should Include

A complete Employee Background Check Attestation includes consent language, screening scope, identity confirmation, signature evidence, data retention notes, and employer contact details for follow-up.

Consent Language

Clear, plain-language consent that meets FCRA requirements and explains the purpose of consumer reports, the types of checks, and the applicant’s rights regarding disclosures and dispute procedures.

Scope

Explicitly state which checks are authorized, including criminal history, motor vehicle records, credit reports where lawful, education verification, and the date range or jurisdictions covered by the search.

Identity

Record identifying details used to perform matches—full name, DOB, SSN or last four where policy dictates—and note ID verification steps taken during collection and document retention location.

Signature Evidence

Capture signature method, authentication level (email, SMS, KBA), timestamp, IP address, and an auditable certificate of completion to support attribution and intent under ESIGN and UETA.

Retention

Include retention instructions and legal basis (I-9, IRC §6501, HIPAA §164.530(j) as applicable), specify retention period, and note secure storage location and access controls for audits.

Employer Contact

Provide the employer contact, HR representative name, phone, and email for questions or disputes; include the background vendor’s contact if a consumer report is issued.

Step-by-Step: Completing the Attestation

Follow these steps to complete and preserve a compliant Employee Background Check Attestation in a digital workflow.

  • 01
    Prepare: Gather IDs, disclosures, and consent language.
  • 02
    Record: Enter screening types, dates, and signer details.
  • 03
    Authenticate: Use authentication method appropriate for risk level.
  • 04
    Archive: Save signed PDF and audit trail securely.

Digital Workflow Settings for Accurate Collection

Configure the digital workflow to collect consent, verify identity, and store the completed attestation securely.

Field Name and Configuration Guidance Set visibility, required flag, and authentication level.
Consent Checkbox Field (Required Setting) Make required and add initial instruction text.
Signature Field and Date Stamp Set signer role and enforce date format MM/DD/YYYY.
Identity Authentication Step (SMS or KBA) Require SMS code for moderate-risk hires.
Document Storage and Access Controls Store PDF with AES-256 encryption and audit logs.

How eSubmission Works for an Attestation

Typical e-submission flow for an Employee Background Check Attestation when using an eSignature platform or RON process.

  • Upload: Upload the attestation PDF or Word document.
  • Place Fields: Add signature, date, and checkbox fields.
  • Authenticate: Select authentication strength (email, SMS, KBA).
  • Complete: Signer reviews and applies signature; audit trail captured.

Platform Capabilities to Support Attestations

ESignature platforms must support secure storage, robust audit trails, common file types, and integration with HR systems.

  • File Formats: PDF, DOCX, and HTML supported.
  • Integrations: Connect to HRIS, ATS, and cloud drives.
  • Security: TLS in transit; AES-256 at rest.

Essential Data Elements to Capture

Full Legal Name: Exact name on government ID.
Date of Birth: Use MM/DD/YYYY format for matching.
SSN or Last Four: Encrypted transmission strongly recommended.
Contact Information: Street address, city, state, ZIP.
Consent Record: Signed attestation with date.
Verification Notes: Record method and ID checks.

Common Preparation Pitfalls to Avoid

  • Using ambiguous consent language that fails to identify the scope of checks, leading to vendor rejections or FCRA disputes.
  • Collecting sensitive data via insecure channels or email without encryption, increasing risk of data breach and regulatory exposure under HIPAA or state privacy laws.
  • Not recording signature metadata (timestamp, IP, auth method) which weakens proof of attribution and makes e-signatures harder to defend under ESIGN or state law.
  • Failing to align retention policy with legal holds, I-9 retention requirements, or potential litigation needs, leading to missing evidence during audits.

Penalties and Legal Risks of Incorrect Attestations

FCRA Noncompliance: Civil penalties, private suits.
I-9 Violations: Fines under 8 CFR §274a.2.
Incorrect SSN: Backup withholding triggers.
Data Breach: HIPAA exposure and fines.
Discrimination Risk: Adverse action without notice.
Recordkeeping Failures: Civil sanctions possible.

Pricing and Feature Comparison for eSignature Providers

Compare typical eSignature plan features and starting prices to choose a compliance-ready option for attestations.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies Varies Varies

FAQs and Troubleshooting for Attestations

Common questions and troubleshooting for completing, signing, and preserving Employee Background Check Attestations in electronic workflows are answered below.


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