Do I need signed consent?

Yes. Obtain explicit, documented consent before requesting CORI. For electronic collection, ensure the consent meets ESIGN's four-part test: intent to sign, consent to electronic records, attribution, and retention capability (15 U.S.C. ch. 96).

Can candidates e-sign the form?

Yes. Electronic signatures are valid under ESIGN and UETA when the signer demonstrates intent and the record can be retained and reproduced. Be sure to provide required consumer disclosures for any consumer-facing process.

Is notarization required?

Not generally for most CORI authorizations, but some states or specific employer policies may require notarization or witness signatures; verify state statutes before proceeding.

What if the CORI shows a conviction?

Follow FCRA (when applicable), state CORI rules, and your adverse-action protocol. Provide required pre-adverse notices, opportunity to dispute, and final adverse-action notices as mandated.

How long must I keep the records?

Retain requests and results according to applicable retention rules: generally at least 3 years, with healthcare-related records retained 6 years (45 CFR §164.530(j)) and other industry-specific periods potentially longer.

Can I use signNow or similar platforms?

Yes. Platforms that comply with ESIGN/UETA, provide audit trails, and offer appropriate security (TLS, AES-256) can be used. Ensure HIPAA BAA or other contractual terms are in place when handling protected data.

Electronic Signature
Templates
HR
Employment CORI Request

Employment CORI Request

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

Employment CORI Request

Personal Information

Full Legal Name Former / Other Names Used (if any) Current Address Phone Number Email Address Date of Birth Social Security Number

Position Information

Position Title Department Reporting Manager Proposed Start Date Compensation

Employment History (Most Recent First)

Employer 1 — Company Name Employer 1 — Job Title Employer 1 — Dates Employed Employer 1 — Primary Responsibilities Employer 1 — Reason for Leaving

Employer 2 — Company Name Employer 2 — Job Title Employer 2 — Dates Employed Employer 2 — Primary Responsibilities Employer 2 — Reason for Leaving

Education

Highest Degree or Certification Institution Graduation Date

Professional References

Reference 1 — Name Reference 1 — Phone Reference 1 — Email Reference 1 — Relationship Reference 2 — Name Reference 2 — Phone Reference 2 — Email Reference 2 — Relationship Reference 3 — Name Reference 3 — Phone Reference 3 — Email Reference 3 — Relationship

Identity Verification

Government-Issued ID Type ID Number Issuing State / Country ID Expiration Date

Criminal History Disclosure

Have you ever been convicted of a felony or misdemeanor, or had a criminal matter adjudicated by a court? Yes No

If yes, provide details (nature of offense, date, jurisdiction, disposition)

Legal Disclosures & Consent

At-Will Employment: I understand that, if hired, my employment is at-will and may be terminated by either party at any time, with or without cause or prior notice, except as otherwise provided by law or written agreement signed by an authorized representative of the employer.

Equal Opportunity: The employer does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or any other characteristic protected by applicable law.

Authorization to Obtain Criminal Record (CORI): I hereby authorize the employer and its designated agents to obtain Criminal Offender Record Information (CORI) and related records concerning me for the purpose of evaluating me for employment. This authorization includes, but is not limited to, state and national criminal history checks, sex offender registry checks, and any other checks allowed by applicable law.

Release: I authorize all courts, law enforcement agencies, correctional institutions, and other persons or agencies that possess such records to release them to the employer or its agent. I release those entities and the employer from any liability for releasing or using such information in accordance with this authorization and applicable law.

Consideration and Use: I understand that the employer will consider the nature, date, and relevance of any criminal history in relation to the position sought. A criminal record will not necessarily disqualify me from employment. I also understand that information obtained may be retained in employment records, consistent with applicable law.

Right to Review and Challenge: I understand I may request a copy of any criminal record obtained and may challenge the accuracy or completeness of the information in accordance with applicable procedures.

I expressly consent to the release and use of CORI as described above. I certify that the information I have provided on this form is true and complete to the best of my knowledge, and that any omission or false statement may be grounds for denial of employment or termination.

Age Certification: I certify that I am at least 18 years of age.

Consent to Background Check: I consent to fingerprinting if required by the employer or by law for the position applied for.

Applicant Certification

I certify under penalty of perjury that all information contained in this Employment CORI Request is true and complete. I understand that omissions or misrepresentations may result in refusal to hire or immediate termination if discovered after hire.

Acknowledgment — Applicant Printed Name Acknowledgment — Applicant Signature (Type name as signature if submitting electronically) Acknowledgment — Date

Additional Employer Use

Employer Contact for CORI Processing Employer Use Only — CORI Completed By

Applicant:

By:

Date:

What the Employment CORI Request Is

The Employment CORI Request is a written authorization used by employers to obtain Criminal Offender Record Information (CORI) for job applicants or employees. It documents the applicant's identity, consent to a criminal record check, the scope of searches authorized, and any employer-specific conditions for employment based on results. Employers and third-party background-screening vendors use the form to ensure compliance with state CORI statutes and applicable federal e-signature laws such as ESIGN (15 U.S.C. ch. 96) and state UETA rules when processing electronically.

Why a Clear CORI Request Matters for Hiring

A properly completed Employment CORI Request documents consent, limits the scope of background checks, and creates an audit trail that supports consistent hiring decisions while reducing legal exposure under state CORI laws and federal e-signature rules.

Who Typically Prepares and Signs CORI Requests

Typical users who prepare or sign Employment CORI Requests include HR teams, hiring managers, and third-party background-screening vendors in regulated or high-liability sectors.

HR departments and recruiters — prepare requests, collect candidate consent, and retain documentation for compliance and audits.
Hiring managers — request role-specific checks and evaluate report relevance under job-relatedness standards.
Background-screening vendors — conduct searches, verify identity, and return results with secure audit logs for the employer.

Coordination among these roles ensures lawful screening, consistent procedures, and defensible documentation of consent and results.

Representative Roles That Handle Employment CORI Requests

HR Manager

Responsible for initiating the Employment CORI Request, securing candidate consent, and maintaining records. Must apply state-specific CORI rules, coordinate adverse-action steps when needed, and ensure retention meets regulatory or company policy requirements.

Background Vendor

A third-party screening provider who performs authorized CORI searches, documents sources and methods, and delivers secure reports. The vendor must follow state statutory limits and maintain an auditable record of identity verification and search results.

Security and Compliance Elements to Include

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest

Audit Trail: Timestamped signer events and IP logs

Access Controls: Role-based access and least-privilege

HIPAA BAA: Business Associate Agreement if PHI present

Retention Policy: Documented storage and deletion schedule

Authentication: Email, SMS, KBA or stronger methods

Key Legal Risks of Incorrect or Missing CORI Requests

Statutory Fines: Civil penalties under state CORI statutes

Discrimination Claims: Violation of fair hiring or FCRA obligations

Adverse-Action Errors: Improper notice or failure to follow process

Privacy Breach Exposure: Unauthorized disclosure of sensitive records

Invalid Consent: Challenge to background check admissibility

Recordkeeping Failures: Regulatory noncompliance and audit risk

Common Mistakes When Preparing Employment CORI Requests

Missing or ambiguous consent language that fails ESIGN/UETA tests and can invalidate electronic authorization.
Collecting full Social Security Numbers unnecessarily, increasing privacy risk and potential state restrictions.
Using outdated state-specific language that does not reflect statutory limits on CORI access or disclosure.
Failing to document identity verification steps or to retain a searchable audit trail for the check.

Step-by-Step: Completing an Employment CORI Request

Follow this concise sequence to collect valid consent and process a CORI check while preserving an audit trail and meeting e-signature requirements.

01

Prepare Form: Use employer letterhead and specify scope of searches.
02

Verify Identity: Collect government ID details and DOB for matching.
03

Obtain Consent: Have candidate sign consent; include ESIGN disclosure if electronic.
04

Complete Check: Submit to vendor and retain results with audit log.

Where to File or Send Completed Requests

Employment CORI Requests are retained by the employer and submitted to licensed background-screening vendors or state agencies according to statutory channels.

Internal HR File: Store signed request in secure personnel record.
Background Vendor: Submit form and identity data per vendor instructions.
State Repository: When required, send to state criminal records office.
Legal Counsel: Route complex or adverse findings for review.

Essential Components of a Professional Employment CORI Request

A complete CORI request includes clearly labeled authorization, identity verification fields, search scope, confidentiality language, and audit-trail provisions to meet legal and practical needs.

Authorization & Consent

Explicit, signed statement authorizing specified criminal-record searches and identifying the requesting employer or vendor.

Identity Verification

Full legal name, date of birth, and one form of ID or SSN last four for accurate record matching.

Scope of Search

Specify jurisdictions (state, national databases) and timeframe for records the employer will review.

Confidentiality Notice

Explain how results will be used, who will see them, and limits on dissemination.

Adverse-Action Steps

Instructions for pre-adverse and adverse notices, including copies of the report and FCRA rights where applicable.

Audit Trail

Signed timestamp, signer identity, and storage location for compliance and future review.

Practical Tips for Accurate and Efficient Completion

Adopt consistent procedures and clear language to reduce errors and speed processing while protecting candidate privacy and meeting legal standards.

Use standardized templates

Employ a single, well-vetted CORI Request template across the organization to ensure consistent consent language and to simplify audits.

Limit identifying data

Collect only the minimum personal data needed for matching; avoid unnecessary full SSNs to reduce privacy and breach risk.

Document consent method

Record whether consent was obtained electronically or on paper, and include the exact text shown to the signer.

Coordinate adverse actions

Follow FCRA and state adverse-action protocols when using CORI results to deny or modify an employment offer.

Timelines and Typical Processing Expectations

Processing times and response deadlines vary with vendor, jurisdictions searched, and candidate responsiveness; allow adequate lead time in hiring schedules.

Vendor Turnaround:

Most state-level CORI checks return within 1–7 business days.

Candidate Response:

Allow 3–7 days for candidate to provide ID or clarify discrepancies.

Adverse-Action Timing:

Follow FCRA notice windows before final adverse decision where applicable.

Retention Requirement:

Retain request and results per regulatory retention timelines.

State Variations:

Some states impose longer processing or distinct notice requirements.

How to Configure an Online CORI Request Workflow

Key settings let you capture consent, verify identity, and route results securely when deploying the request as an electronic form.

Template	Use a locked template with consent and scope language.
Conditional Fields	Show additional fields only when candidates report a record.
Authentication	Require email + SMS or stronger verification for signer identity.
Bulk Send	Enable bulk delivery for high-volume hiring.
Storage	Route completed requests to encrypted HR repository.

Digital Signing and eSubmission Considerations

Ensure the chosen e-signature platform supports secure authentication, detailed audit trails, and appropriate compliance certifications for sensitive screening data.

Authentication Options: Email, SMS, KBA, or multifactor
Integrations: HRIS, background vendors, and cloud storage
File Formats: PDF, DOCX accepted; preserve audit trail

Sample eSignature Pricing and Feature Comparison

Comparison of common eSignature vendors for processing Employment CORI Requests; signNow appears first per comparison conventions.

	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, no credit card	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes (Business Premium)	Yes	Yes	Yes	Limited
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

FAQs and Troubleshooting for Employment CORI Requests

Answers to common questions about completing, signing, and storing Employment CORI Requests, including electronic execution and record retention.

Need help? Contact support

Do I need signed consent?
Yes. Obtain explicit, documented consent before requesting CORI. For electronic collection, ensure the consent meets ESIGN's four-part test: intent to sign, consent to electronic records, attribution, and retention capability (15 U.S.C. ch. 96).
Can candidates e-sign the form?
Yes. Electronic signatures are valid under ESIGN and UETA when the signer demonstrates intent and the record can be retained and reproduced. Be sure to provide required consumer disclosures for any consumer-facing process.
Is notarization required?
Not generally for most CORI authorizations, but some states or specific employer policies may require notarization or witness signatures; verify state statutes before proceeding.
What if the CORI shows a conviction?
Follow FCRA (when applicable), state CORI rules, and your adverse-action protocol. Provide required pre-adverse notices, opportunity to dispute, and final adverse-action notices as mandated.
How long must I keep the records?
Retain requests and results according to applicable retention rules: generally at least 3 years, with healthcare-related records retained 6 years (45 CFR §164.530(j)) and other industry-specific periods potentially longer.
Can I use signNow or similar platforms?
Yes. Platforms that comply with ESIGN/UETA, provide audit trails, and offer appropriate security (TLS, AES-256) can be used. Ensure HIPAA BAA or other contractual terms are in place when handling protected data.

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