Fill and Sign the Employee Do Form

EMPLOYEE PERMISSION TO DO A BACKGROUND CHECK In consideration of my prospective employment possibility with       , I hereby grant permission for a general background check to be conducted through investigation of my personal and employment history. I understand and acknowledge that any background investigation that I authorize may include a credit check as complies with the Fair Credit Reporting Act. This background check will include, but is not limited to, verification of any dates, names, facts, or circumstances provided by me on my employment application. I further understand that no additional notice shall be required to conduct additional background checks once/if I become an employee. ( Exception- under California law an individual must be notified every time a background check is performed) I specifically give permission to said company to contact all previous employers for purposes of an employment reference and verification. I agree to save harmless for any action in defamation or other suits as may arise regarding statements made to said company, any and all past and present employers, supervisors, managers, and anyone in a direct authoritative position over me. I consent to the release of relevant personal and employment information as may pertain to the position for which I am applying or the position for which I am being considered. I further give permission to the aforementioned company to conduct a check of federal, state, or local agencies and courts and to receive a copy of any governmental information that may be compiled concerning my credit, employment, or any instances of moral turpitude. In the event that the law does not provide prospective or present employers access to such information, I hereby delegate said company as my agent for the receipt of such information. I hereby authorize the aforementioned company to conduct a medical background check of any and all medical records in my name or any alias used by me whether concerning physical, or emotional conditions for which I was being treated. I agree to release from liability any medical facility, provider, reporting agency, or medical professional for any information provided to said company. I agree to cooperate fully with said company’s background investigation and further agree to sign any necessary releases to obtain access to relevant information. I further understand that consenting to and complying with a request to perform a background check does not in any way constitute an offer for employment.             Applicant Name Date _____________________ Signature