Is an electronic signature valid for CORI consent?

Yes. Electronic signatures can be valid where ESIGN and relevant state laws permit electronic consent. Ensure the method captures intent, attribution, and a reproducible record of the signed authorization.

What if an applicant declines to sign?

If an applicant refuses authorization, you generally may not proceed with the background check. Treat refusal as part of your hiring process and document any decision consistent with your non-discrimination policies.

Can I collect SSN on the form?

Collect SSN only when necessary for accurate identity matching and where permitted by law. Limit access to SSNs, and follow privacy and data-minimization practices to reduce misuse risk.

How long should I keep CORI results?

Retention depends on state and industry rules; maintain records long enough to support hiring decisions and regulatory audits, and purge per your documented retention schedule.

What steps follow an adverse finding?

Follow required adverse-action notices under federal and state laws: provide a pre-adverse notice with a copy of the report and an opportunity to dispute before final action.

Who can sign the CORI request for the employer?

An authorized employer representative with hiring or HR authority should sign or electronically authorize the request; document the signer’s role and contact details on the form.

Electronic Signature
Templates
HR
Employment CORI Request Form

Employment CORI Request Form

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

EMPLOYMENT CORI REQUEST FORM

Personal Information

Full Legal Name:

Other Names Used (maiden, aliases) Date of Birth Social Security Number Current Address

Phone

Email

Position Information

Position Title Department / Location

Reporting Manager

Proposed Start Date

Compensation

Employment Type: Full-time Part-time Temporary/Seasonal

Authorization for CORI (Criminal Offender Record Information)

Employer Requesting CORI:

Employer Address:

I authorize the above-named employer and its designated agents to obtain my Criminal Offender Record Information (CORI) as part of the application for employment, for periodic rechecks while employed, and for other employment purposes permitted by law. I understand that CORI may include conviction information and sentencing data maintained by criminal justice agencies.

I understand that failure to disclose required information or providing false information may disqualify me from employment or subject me to disciplinary action. I authorize the release of CORI to the employer for employment-related determinations and understand that the employer will comply with applicable statutes and regulations governing the access, use, and retention of such records.

Consent to Background Checks and Records: I also authorize the employer to obtain background checks, including but not limited to national criminal database searches, sex offender registry checks, and verification of my driving record where job-related and permitted by law. I release the employer and any reporting agency from liability for relying on such information in employment decisions.

Background Disclosure

Have you ever been convicted of a felony or misdemeanor (excluding minor traffic offenses)? Yes No

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

Are you currently subject to any pending criminal charges? Yes No

Employment History (Most Recent First)

Employer 1 — Company Name

Primary Duties / Responsibilities Reason for Leaving

Employer 2 — Company Name

Primary Duties / Responsibilities Reason for Leaving

Education

Highest Degree or Diploma Institution Graduation Date

Professional References

Provide three professional references who can verify your work history and qualifications.

Reference 1 — Name Reference 2 — Name Reference 3 — Name

Legal Notices and Employer Policies

At-Will Employment: Nothing in this form or in any prior or subsequent communications shall be construed to create a contract of employment for any specified duration. Employment, if offered and accepted, is at-will and may be terminated by either party at any time, with or without cause, subject to applicable law.

Equal Employment Opportunity: The employer provides equal employment opportunities and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, marital status, sexual orientation, or any other protected characteristic under applicable law. CORI information will be considered only as permitted by law and in relation to job requirements.

Applicant Certification and Authorization

I certify that all information provided on this form and any attachments is true, accurate, and complete to the best of my knowledge. I understand that falsification, omission, or misrepresentation of information may result in refusal to hire, withdrawal of a conditional offer, or discipline up to and including termination if employed.

By signing below I expressly authorize the employer and its designated agents to obtain CORI and other background information about me and to use that information in employment decisions. I understand the employer will maintain the confidentiality of CORI consistent with applicable laws and will provide me any disclosures or rights required by law prior to adverse action.

Applicant Certification: I certify the above statements are true and complete.

Applicant Name:

Signature:

Date:

What the Employment CORI Request Form Is

The Employment CORI Request Form is a standardized document used by employers and authorized organizations to request Criminal Offender Record Information (CORI) or similar criminal-background reports for hiring, licensing, or placement decisions. It documents applicant consent, identifies the applicant and requesting organization, and authorizes a background search through a state repository or authorized vendor. Many jurisdictions place specific limits on which positions may trigger a CORI check and how results may be used; electronic platforms can capture consent, preserve an audit trail, and securely transmit the request to screening providers.

Why a Proper Employment CORI Request Form Matters

A clear, compliant CORI request protects both the applicant and the employer by documenting consent, limiting scope to job-related information, and creating an auditable record. Properly completed forms reduce legal risk, speed screening, and help ensure decisions follow applicable state and federal rules for background checks.

Who Typically Uses the Employment CORI Request Form

Organizations that routinely screen candidates rely on the Employment CORI Request Form to obtain legal consent and required identity data before ordering a background check.

Human resources teams and hiring managers — Use the form to authorize pre-employment checks and document role-specific screening.
Volunteer coordinators and placement agencies — Capture consent for sensitive roles working with children, elders, or vulnerable adults.
Licensing bodies and contractors — Request CORI for regulatory compliance or to meet contractual obligations.

Use of the form should align with local fair-hiring laws and any industry-specific screening standards to avoid discrimination or improper disclosure.

How to Complete the Employment CORI Request Form — Step by Step

Follow these four practical steps to collect consent, submit a CORI request, and record results while keeping compliance and data security in mind.

01

Prepare: Confirm job-related screening policy and required form version.
02

Collect consent: Obtain signed applicant authorization and required identity details.
03

Submit request: Send the completed form to an authorized background vendor or state repository.
04

Record decision: Document results, any adverse-action steps, and retention details.

Key Components to Include in a Professional CORI Request

A complete employment CORI form groups employer details, applicant identity, explicit consent language, screening scope, vendor instructions, and signature fields to meet legal and operational needs.

Employer Identification

Employer name and contact information so the screening provider knows the authorized requester and can return results securely and to the correct party.

Applicant Details

Fields for full legal name, DOB, SSN (if applicable), and current plus prior addresses to ensure accurate criminal history matching.

Consent Language

Clear statement that the applicant authorizes a criminal record check; include scope, purpose, and any limits required by state law.

Scope of Search

Specify whether the search is statewide, multi-state, nationwide, or limited to certain courts or record types.

Screening Vendor Instructions

Provide vendor identifiers, return method (secure portal/email), and any required reference numbers to route results correctly.

Signature and Date

Designated signature block for applicant (and employer representative if needed) capturing name, signature, and signature date.

Required Data Elements at a Glance

Applicant Name: Full legal name

Date of Birth: MM/DD/YYYY

SSN: If permitted

Current Address: Street, city, state, ZIP

Consent Date: Signature date

Requester Info: Employer contact

Online Setup Checklist for Electronic CORI Requests

Configure your digital workflow to capture consent, verify identity, and preserve an auditable record when submitting CORI requests electronically.

Field	Configuration
Consent Checkbox	Required
Identity Verification	ID upload and SMS 2FA
Retention Policy	Set per legal minimums
Audit Trail	Enable timestamps and IP logging

Technical Requirements for eSubmission and eSigning

Electronic submission requires file-format support, secure transmission, signer authentication, and preserved audit logs.

Document Formats: PDF and DOCX
Integrations: Salesforce, NetSuite, Google Workspace
Authentication: Email link, SMS code, or KBA

Choose a platform that supports secure storage, audit trails, and the integrations needed to route CORI requests to your screening provider.

Where to File, Send, or Submit the Employment CORI Request

CORI requests are sent either to a state criminal records repository (where available) or to an authorized background-check vendor; processing differs by route.

Upload Form: Attach completed request to vendor portal or state site
Place Fields: Mark signature, date, and identity fields
Send to Signer: Email or secure link for applicant signature
Receive Results: Vendor returns report to employer contact

Typical Timelines and Processing Expectations

Processing times and deadlines vary by jurisdiction and vendor; plan the hiring timeline accordingly and allow for re-checks if identity mismatches occur.

Submission Window:

No universal deadline; submit at pre-hire stage

Vendor Processing:

Typically 1–10 business days

Applicant Response:

Obtain signed consent before ordering

Adverse Action Timing:

Follow notice timing under federal/state laws

Re-checks:

Schedule periodic rechecks if required

Key Milestones in the CORI Request Process

A sequential view of core stages helps employers coordinate hiring timelines and compliance steps.

01

Initiate Request

Employer prepares form and confirms role-related need.

02

Consent Obtained

Applicant signs authorizing the background check.

03

Search Performed

Vendor/state executes the criminal history search.

04

Decision Documented

Employer reviews report and records the hiring outcome.

Penalties and Legal Risks of an Incorrect or Misused CORI Form

Discrimination Risk: Claims for unlawful adverse action

Privacy Violation: Improper disclosure of criminal records

Invalid Consent: Insufficient authorization can void checks

Recordkeeping Violations: Failing to retain required logs

Contractual Breach: Vendor or licensing noncompliance

Operational Delays: Incomplete data causes rechecks

Common Mistakes to Avoid When Preparing a CORI Request

Missing or incorrect applicant identifiers that lead to mismatched or delayed reports and require time-consuming manual review.
Using overly broad scope language that exceeds job-related needs and may violate fair-hiring restrictions in some states.
Failing to capture explicit and dated consent in written or auditable electronic form before ordering a check.
Keeping results longer than permitted or returning reports to unauthorized parties, creating privacy and compliance exposure.

eSignature Pricing Comparison for Processing CORI Requests

Platform pricing and features vary by plan; include eSignature capability, audit trails, HIPAA support, and bulk-send features when selecting a provider.

	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	Yes, 7-day trial	No	No	Yes, limited	Yes, limited
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Real-World Examples of CORI Request Use

These brief examples show how organizations apply CORI requests in hiring and placement contexts while maintaining compliance and operational efficiency.

Optica Ventures (COO)

Optica centralized background checks across hires to reduce delays and errors.

They applied consistent consent capture for every candidate.
As a result, workflows became auditable and turnaround time shortened while maintaining legally required disclosures and applicant privacy safeguards.

Martin Properties (Founder)

A property-management firm used electronic CORI requests for contractors and tenant screening.

The firm standardized the authorization language and vendor routing.
This reduced manual handling, lowered the incidence of mismatched records, and helped the firm document fair-hiring practices consistently across locations.

Practical Tips for Accurate and Efficient CORI Requests

Follow these best practices to minimize errors, preserve privacy, and speed background checks without sacrificing compliance.

Limit scope to job relevance

Only request the types of criminal history that are materially related to the duties of the position to reduce legal risk and unnecessary disclosures.

Capture clear, dated consent

Use unambiguous authorization language and retain the signed or electronic consent record before initiating any check.

Use precise identity fields

Collect full legal names, DOB, prior addresses, and SSN when permitted to avoid mismatches and manual vendor rework.

Preserve an audit trail

Keep timestamps, IP addresses, and versioned documents to demonstrate compliance and support any later adverse-action steps.

FAQs: Common Questions About the Employment CORI Request Form

Answers to frequent questions about consent, e-signing, retention, and what to do when results affect hiring decisions.

Need help? Contact support

Is an electronic signature valid for CORI consent?
Yes. Electronic signatures can be valid where ESIGN and relevant state laws permit electronic consent. Ensure the method captures intent, attribution, and a reproducible record of the signed authorization.
What if an applicant declines to sign?
If an applicant refuses authorization, you generally may not proceed with the background check. Treat refusal as part of your hiring process and document any decision consistent with your non-discrimination policies.
Can I collect SSN on the form?
Collect SSN only when necessary for accurate identity matching and where permitted by law. Limit access to SSNs, and follow privacy and data-minimization practices to reduce misuse risk.
How long should I keep CORI results?
Retention depends on state and industry rules; maintain records long enough to support hiring decisions and regulatory audits, and purge per your documented retention schedule.
What steps follow an adverse finding?
Follow required adverse-action notices under federal and state laws: provide a pre-adverse notice with a copy of the report and an opportunity to dispute before final action.
Who can sign the CORI request for the employer?
An authorized employer representative with hiring or HR authority should sign or electronically authorize the request; document the signer’s role and contact details on the form.

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