Can the form be e-signed?

Yes. Electronic signatures meet legal requirements under the ESIGN Act (15 U.S.C. §7001) and UETA in most jurisdictions when intent, consent, attribution, and record retention are satisfied. Certain narrow exceptions (e.g., testamentary documents) remain ineligible for e-signature.

Does the authorization require notarization?

Generally no. Employee Disclosure and Authorization forms rarely require notarization for routine background checks. Some states or specific transactions may require notarized consent for certain verification types; verify state rules or industry-specific regulations before requiring a notary.

What if an applicant refuses consent?

Refusal to sign typically prevents the employer from ordering consumer reports or conducting certain verifications. Employers may base hiring decisions on lack of consent, but must apply policies consistently and provide required notices, avoiding discrimination claims under federal or state law.

How long should I keep the signed form?

Retain the signed authorization according to applicable retention rules: I-9 and personnel records guidance, IRS requirements for payroll-related documents, and HIPAA six-year rules for protected health information. See employer retention policies and consult counsel for state-specific obligations.

Can I use conditional fields in the form?

Yes. Use conditional or formula fields to tailor disclosures and capture role-specific consents, but ensure the displayed language remains FCRA-compliant and that all routed signers receive appropriate copies and notices required by law.

How can errors on the form be corrected?

Do not alter a signed record. If an error exists, prepare an amendment or corrective statement and obtain a new signature or initial plus date. Document the correction process and retain both original and corrected versions for audit and legal defensibility.

Electronic Signature
Templates
HR
Employee Disclosure and Authorization

Employee Disclosure and Authorization

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

Employee Disclosure and Authorization

Personal Information

Full Legal Name Current Address

Primary Phone

Email

Date of Birth: Last 4 of SSN:

Position Information

Position / Job Title Department Reporting Manager

Proposed Start Date: Salary / Rate:

Employment Type: Full-time Part-time Temporary Contract

Employment History (Most recent first)

Employer 1 - Company Name

Primary Responsibilities Reason for Leaving Employer 2 - Company Name

Primary Responsibilities Reason for Leaving

Education

Highest Degree or Diploma

Graduation Date:

References

Reference 1 Reference 2 Reference 3

Legal Disclosures & Notices

At-Will Employment: I understand that my employment, if any, with the organization is at-will. Either I or the employer may terminate the employment relationship at any time, with or without cause or notice, unless a separate written agreement signed by an authorized company representative states otherwise.

Equal Opportunity: The employer is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, genetic information, or any other basis protected by applicable law.

Disclosure and Authorization to Obtain Consumer Reports and Investigative Reports

I hereby authorize the employer, its agents, contractors and designated representatives to obtain consumer reports, background investigations, investigative consumer reports, motor vehicle records, credit reports where job-related and permitted by law, drug and alcohol testing results, and any other information in connection with my application for employment and, if applicable, during my employment. This authorization includes, but is not limited to, verification of my past employment, education, professional credentials, driving record, credit history, criminal history, and other records or reports that pertain to my suitability for employment.

I understand that information obtained may be used to make employment decisions. I also understand that I have the right to request disclosure of the nature and scope of any investigative consumer report. By signing below I authorize the release of information and records to the employer and release all persons and entities providing such information from any liability arising from the disclosure.

Scope of Authorization: The scope of this authorization is broad and shall include, without limitation, consumer reports, background checks, criminal background checks, employment verifications, education verifications, reference checks, motor vehicle records, credit history checks (where permitted by law), and drug/alcohol testing. The employer may use third-party consumer reporting agencies to obtain this information.

Selection (check all that apply): Background check / consumer report Credit check Motor vehicle record Drug and alcohol testing Fingerprinting and identity verification Social media and public internet search

Criminal Record Disclosure

Have you ever been convicted of or pleaded guilty or no contest to a felony or misdemeanor? (Convictions may be considered in relation to the position for which you have applied.) Yes No

If yes, provide date(s), jurisdiction, and explanation

Consent to Contact Previous Employers and References

I authorize the employer and its agents to contact any and all of my former employers, educational institutions, references, and other persons or entities to obtain information regarding my background and qualifications. I understand that such information may include details of job performance, disciplinary records, reasons for separation, and eligibility for rehire.

Release: I hereby release from liability any person or entity that provides information to the employer or its agents in good faith and without malice in response to inquiries relating to my background, and I release the employer and its agents from any liability with respect to the use of such information.

Applicant Certification

I certify that the information I have provided to the employer in connection with my application and this authorization is true and complete to the best of my knowledge. I understand that any false or misleading statements, omissions, or misrepresentations may result in denial of employment or, if employed, discipline up to and including termination.

I acknowledge receipt of this Disclosure and Authorization and understand that this authorization will remain in effect for the duration permitted by applicable law or until revoked by me in writing. I understand that revocation will not affect any action taken in reliance upon this authorization prior to receipt of my written revocation.

I further acknowledge that the employer may provide me with an adverse action notice if any decision is based in whole or in part on information obtained in a consumer report.

Authorization: By signing below, I authorize all persons, schools, current and former employers, businesses, and law enforcement agencies to release to the employer or its agents any and all information requested, and I release those parties from any liability for providing such information.

Additional Comments or Clarifications

Employee Name:

Signature:

Date:

What the Employee Disclosure and Authorization Is

An Employee Disclosure and Authorization is a signed document that allows an employer to obtain consumer reports, verify employment eligibility, and collect background information necessary for hiring or continued employment. The form typically explains the types of information that may be requested — for example, criminal history, credit reports for certain roles, driving records, and education or employment verifications — and obtains the applicant’s written consent. This document helps employers comply with disclosure and consent requirements under federal and state laws and documents the applicant’s permission to access protected information.

Why this Form Matters for Compliance and Hiring

Provides a clear, written record of applicant consent for background checks, consumer reports, and employment verifications, reducing legal risk and demonstrating compliance with ESIGN and paper disclosure obligations under federal and state consumer reporting and employment laws.

Who Completes and Relies on this Authorization

Employers and HR teams use this form to document consent for background checks and verify information during hiring and periodic reviews.

HR managers responsible for recruitment, onboarding, and personnel recordkeeping tasks.
Hiring managers who request background checks, credential verifications, or reference contacts.
Third-party screening vendors and internal compliance officers overseeing report usage.

Employees and applicants should read disclosures carefully; the signed authorization becomes part of the personnel file and compliance records.

Core Sections to Include in a Professional Authorization

Core sections include disclosure language, consent statement, scope of checks, authorization signature block, reauthorization terms, and a notice regarding background report consumer rights.

Disclosure

Specifies what types of information may be obtained (criminal records, credit history when applicable, driving record) and explains purpose, such as employment decisions, licensing, or safety-sensitive positions.

Consent

A clear written consent statement confirming the applicant authorizes collection of consumer reports and other verifications; includes Acknowledgement of rights under FCRA when consumer reports are used.

Scope

Defines scope and timeframe for searches, whether ongoing monitoring is permitted, geographical limits, and any role-based justification for sensitive checks like credit or driving records.

Signature

Signature block for applicant with date and printed name; includes notation that electronic signatures meet legal requirements under ESIGN and UETA where applicable and provides signing method options (electronic or handwritten).

Reauthorization

Terms for reauthorization or additional checks during employment, including how employer will notify the worker and any opt-out or dispute procedures and retention of consent records.

Consumer Rights

If consumer reports are used, include FCRA-required disclosure and consumer rights language explaining dispute process, source contact information, and adverse action procedures and how to obtain a copy of the report.

Step-by-Step: Completing and Executing the Authorization

Follow a consistent sequence to deliver disclosures, capture consent, order checks, and document outcomes for auditability and compliance.

01

Prepare Document: Insert FCRA-compliant disclosure and required fields.
02

Deliver Disclosure: Provide the form to the applicant and obtain consent.
03

Order Checks: Submit requests to screening vendors or CRAs.
04

Record Decision: Document results and any adverse-action steps taken.

Typical Digital Workflow Settings

Configure a digital workflow to capture consent, route approvals, and archive signed records in personnel files.

Field	Configuration
Disclosure Text	Insert FCRA-compliant disclosure and consumer rights text.
Consent Capture	Require signed checkbox and date stamp.
Signer Auth	Use email link with optional SMS code.
Record Storage	Archive PDF with audit trail in HR system.

How the Authorization Process Typically Works

Typical workflow covers disclosure delivery, consent capture, background vendor request, receipt and review of reports for hiring decisions.

Send Notice: Provide written disclosure and obtain consent.
Order Reports: Submit requests to consumer reporting agencies.
Review Findings: HR reviews results and documents determination.
Adverse Action: Issue FCRA adverse-action notice when applicable.

Platform Considerations for Digital Execution

Digital signing options vary; ensure your platform supports secure capture, audit trails, and the authentication level required by law or policy.

File Formats: Export to PDF, PDF/A, and DOCX.
Integrations: Connects to HRIS, ATS, and cloud storage.
Authentication: Email, SMS code, or advanced KBA.

Security and Compliance Controls to Include

Encryption: AES-256 encryption at rest.

In Transit: Encrypted with TLS 1.2 and 1.3.

Access Controls: Role-based permissions and MFA.

Audit Trail: Time-stamped logs, IP, actions.

BAA Available: HIPAA BAA offered when required.

Standards: SOC 2 Type II and ISO 27001.

Common Preparation Pitfalls to Avoid

Using generic or unclear disclosure language that fails to meet FCRA or state-specific notice requirements, creating risk of successful adverse-action appeals or litigation.
Collecting consent verbally or by email without an auditable signature trace and timestamp, which may not satisfy ESIGN record-retention or consent demonstration standards.
Failing to provide required FCRA disclosures before obtaining consumer reports, or neglecting adverse-action notices after negative employment decisions.
Not updating reauthorization terms for periodic checks, leading to stale consent arguments and regulatory scrutiny in ongoing-employment screenings.

Immediate Risks and Legal Consequences

FCRA Noncompliance: Adverse action risk.

I-9 Violations: Civil fines per violation.

Incorrect Consent: Report suppression or litigation.

Data Breach: State breach laws apply.

False Info: Termination or liability.

Late Disclosure: Administrative fines possible.

eSignature Pricing and Feature Snapshot for This Document

Quick vendor feature and price comparison for eSignature solutions commonly used to execute Employee Disclosure and Authorization documents.

	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 by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes	Yes	Yes	Yes	Varies
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No envelope cap	100 envelopes/user/year cap	Varies by plan	Varies by plan	Varies by plan

FAQs and Practical Troubleshooting for the Authorization

[INTRO] Answers to common questions about completing, signing, and storing the Employee Disclosure and Authorization to help ensure compliance and practical handling.

Need help? Contact support

Can the form be e-signed?
Yes. Electronic signatures meet legal requirements under the ESIGN Act (15 U.S.C. §7001) and UETA in most jurisdictions when intent, consent, attribution, and record retention are satisfied. Certain narrow exceptions (e.g., testamentary documents) remain ineligible for e-signature.
Does the authorization require notarization?
Generally no. Employee Disclosure and Authorization forms rarely require notarization for routine background checks. Some states or specific transactions may require notarized consent for certain verification types; verify state rules or industry-specific regulations before requiring a notary.
What if an applicant refuses consent?
Refusal to sign typically prevents the employer from ordering consumer reports or conducting certain verifications. Employers may base hiring decisions on lack of consent, but must apply policies consistently and provide required notices, avoiding discrimination claims under federal or state law.
How long should I keep the signed form?
Retain the signed authorization according to applicable retention rules: I-9 and personnel records guidance, IRS requirements for payroll-related documents, and HIPAA six-year rules for protected health information. See employer retention policies and consult counsel for state-specific obligations.
Can I use conditional fields in the form?
Yes. Use conditional or formula fields to tailor disclosures and capture role-specific consents, but ensure the displayed language remains FCRA-compliant and that all routed signers receive appropriate copies and notices required by law.
How can errors on the form be corrected?
Do not alter a signed record. If an error exists, prepare an amendment or corrective statement and obtain a new signature or initial plus date. Document the correction process and retain both original and corrected versions for audit and legal defensibility.

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