Can the declaration be signed electronically?

Yes. Electronic signatures are legally equivalent to handwritten signatures under the ESIGN Act (15 U.S.C. ch. 96) and state UETA laws when intent, consent, attribution, and reliable record retention are present.

Do applicants need a separate consent for background checks?

Yes. Employers should obtain a clear, stand-alone consent for criminal-history checks and provide any consumer disclosures required under the Fair Credit Reporting Act where a third-party consumer-reporting agency is used.

What if a signer disputes accuracy later?

Maintain the signed record, audit trail, and identity-verification artifacts; these support adjudication and demonstrate the employer’s reliance on the signer’s attestation during hiring decisions.

Are sealed or expunged records reportable?

State laws differ. Some jurisdictions allow disclosure of expunged or sealed records in limited contexts; employers should consult state law and legal counsel before requiring disclosure.

When is notarization required?

Notarization is uncommon for routine employment declarations but may be required for certain attestations in specific states or for executives; consult state notary rules when in doubt.

How long should I keep the signed declaration?

Retain for the active employment term plus at least 3 years, longer where industry rules apply (e.g., HIPAA six years or other state-specific periods).

Electronic Signature
Templates
HR
Employment Criminal Declaration

Employment Criminal Declaration

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

EMPLOYMENT CRIMINAL DECLARATION

Personal Information

Full Legal Name Current Address Primary Phone Email Address Date of Birth

Position Information

Position Applied For / Job Title Department Hiring Manager / Supervisor Proposed Start Date

Employment History

Provide your two most recent employers. If none, indicate "N/A".

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 or Completion Date

References

Provide three professional references who can attest to your work history and character.

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

Legal Disclosures

At-Will Employment: If hired, your employment will be on an at-will basis unless a written agreement signed by an authorized representative of the Company states otherwise. Either you or the Company may terminate the employment relationship at any time, for any lawful reason, with or without cause or advance notice.

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

Criminal History Declaration

Definitions: For purposes of this declaration, "convicted" means a plea of guilty, plea of nolo contendere, a verdict of guilty, or any other finding of guilt by a court. A conviction that has been sealed, expunged, voided, or otherwise rendered legally invalid should still be disclosed unless applicable law expressly prohibits disclosure.

Answer the following questions fully and accurately. For any question answered "Yes," provide a detailed explanation in the space provided below including dates, jurisdictions, and final disposition.

Have you ever been convicted of a felony?

Yes No

Have you ever been convicted of a misdemeanor?

Yes No

Are there any criminal charges currently pending against you?

Yes No

Have you ever had a conviction sealed, expunged, or set aside?

Yes No

Have you been convicted of an offense involving dishonesty, theft, fraud, or moral turpitude?

Yes No

If you answered "Yes" to any of the questions above, provide details below. If none, enter "None". Include date(s), jurisdiction, offense(s), disposition and sentence.

The Company may conduct a criminal background check and verify the accuracy of this declaration. I understand that failure to disclose requested information, providing false or misleading information, or omitting material facts may disqualify me from employment or may result in termination if discovered after hire.

Authorization and Release

I authorize the Company and its agents to investigate and obtain information regarding my criminal history, and to contact previous employers, references, schools and other persons or entities I have identified in this form for the purpose of evaluating my application. I release from liability any person providing such information and the Company for use of such information in connection with my application.

I acknowledge and authorize the background check and inquiries described above.

Applicant Certification

I certify that all statements and answers provided in this Employment Criminal Declaration are true, correct and complete to the best of my knowledge. I understand that the Company may rely on this information in making employment decisions and that any misrepresentation, omission or falsification may disqualify me from employment or subject me to disciplinary action, up to and including termination. I understand that employment, if offered, is conditioned upon the results of any background check and the verification of information provided.

I further understand that this declaration and any background checks are conducted in accordance with applicable law; where required by law, the Company will provide any requisite notices or obtain separate consent prior to conducting a consumer report.

Signature of Applicant

Applicant Name:

Signature:

Date:

What an Employment Criminal Declaration is and when it’s used

An Employment Criminal Declaration is a signed statement in which a job applicant or employee discloses past criminal convictions, pending charges, or other adjudicative findings relevant to employment. Employers typically use it during hiring, onboarding, or in connection with background checks to document the applicant’s representations and to support lawful hiring decisions. The form may be required by company policy, regulatory compliance, or contractual obligations for sensitive roles. Electronic versions may be executed under federal and state e-signature laws when executed with appropriate consent and authentication.

Why this declaration matters to employers and applicants

The Employment Criminal Declaration creates a clear, dated record of an individual’s disclosures, supports consistent screening practices, and helps employers meet legal and regulatory obligations while documenting consent for background checks under state and federal rules.

Who typically completes or requests this declaration

Employers and HR teams use the Employment Criminal Declaration to standardize background-check intake and to document an applicant’s attestation before hiring.

Job applicants and new hires who are undergoing screening or onboarding
Human resources and recruiting teams responsible for candidate vetting
Background-check providers and in-house compliance reviewers

Hiring managers, background-screening vendors, and compliance officers rely on completed declarations to make role-appropriate decisions and to maintain defensible hiring records.

Typical signatories and decision-makers

Applicant / Signer

An individual seeking employment or currently employed who must attest to the accuracy of criminal-history information. Their signature is the primary legal representation of the facts stated and is used to match against background-check results.

Employer Representative

An HR or hiring official who certifies receipt, records the declaration in personnel files, and authorizes any follow-up background checks required by policy or law.

Core elements to include in a professional declaration

A complete Employment Criminal Declaration combines clear questions, defined time frames, signature and date fields, consent language for background checks, and a privacy notice describing how information will be used and retained.

Identification

Full legal name, date of birth, and contact details to match against screening records and verify identity.

Disclosure Questions

Direct, role-relevant yes/no questions on convictions, pending charges, and sealed/expunged records with defined lookback periods.

Context Fields

Open fields for explanations, dates, jurisdictions, and disposition so reviewers can assess severity and relevance.

Consent for Background Check

Clear, separate consent statement authorizing criminal-history checks and naming the screening vendor where required.

Signature and Date

Signer signature block and date, and optional employer acknowledgement, to document the attestation moment.

Privacy and Retention

A short notice describing how long records are kept, who has access, and a reference to the company’s data-protection policy.

Step-by-step: completing an Employment Criminal Declaration

Complete the form in the order presented to avoid omissions, then confirm identity and provide consent for any required checks.

01

1. Enter identity: Provide full legal name, DOB, and address.
02

2. Answer disclosures: Respond yes/no and add required details for any affirmative answers.
03

3. Provide consent: Check and sign the consent statement for criminal-history checks.
04

4. Submit and retain: Sign, date, and return per employer instructions; keep a copy for your records.

Typical flow from form completion to hiring decision

The Employment Criminal Declaration fits into a predictable workflow that links applicant attestations to screening outcomes and final hiring actions.

Form Received: Employer collects declaration and confirms identity.
Background Check: Screening vendor runs searches using provided identifiers.
Adjudication: HR reviews results against policy and role criteria.
Decision Logging: Hiring decision and rationale are recorded with the signed declaration.

Configuring an electronic intake workflow

Design fields and routing so the declaration is captured, authenticated, and stored with minimal manual handling.

Field	Configuration
Identity Fields	Require name, DOB, and address; mark as mandatory.
Disclosure Blocks	Use conditional fields to reveal explanation boxes only for 'yes' answers.
Consent Capture	Include a separate consent checkbox and a consumer disclosure if required.
Routing	Auto-route signed forms to HR, background vendor, and a secure archive.

Technical considerations for e-submission and signing

Choose a signing platform that supports audit trails, secure storage, and required authentication for identity verification.

File formats: PDF and Word DOCX are standard; ensure the platform preserves form fields
Authentication: Use email links, SMS codes, or stronger methods (KBA or MFA) per sensitivity
Integrations: Confirm connectors for HRIS, background vendors, and cloud storage

Essential security and compliance features to document

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

Audit Trail: Timestamps, IP, and action logs

Access Controls: Role-based permissions

Retention Policy: Documented retention schedules

BAA Availability: Business Associate Agreement for HIPAA needs

21 CFR / SOC 2: Support for regulatory control frameworks

Risks and legal consequences of incorrect or incomplete declarations

Employment Liability: Wrongful-hire claims or negligence exposure

Regulatory Fines: Penalties under sector rules for noncompliance

Data Privacy Breach: HIPAA/CCPA penalties if PHI handled incorrectly

Adverse Action Errors: Failure to follow FCRA procedures when taking adverse action

I-9 Timing: Retention errors can trigger DHS fines for related records

Criminal Liability: False statements may carry legal consequences in some jurisdictions

Common mistakes to avoid when preparing the declaration

Using vague lookback windows that differ from company policy and screening scope
Failing to obtain separate, clear consent for background checks where required
Mismatching names or DOBs that prevent accurate background matches
Not retaining a signed copy or failing to log the audit trail

Timing considerations and deadlines to keep in mind

Track both the moment of signing and any regulatory deadlines tied to screening, adverse-action notices, or retention obligations.

Signing date accuracy:

Record in MM/DD/YYYY format to time statutory deadlines

Adverse-action timing:

Comply with FCRA notice timing after an adverse decision

I-9 retention:

Keep for required period after termination per 8 CFR §274a.2

Record access requests:

Respond to employee access requests within statutory windows

Background-check updates:

Recheck frequency per policy or regulatory requirement

Key milestones from intake to final record

Typical processing stages help employers manage the review and decision timeline with clear checkpoints.

01

Intake Completed

Signed declaration received and identity confirmed.

02

Background Ordered

Vendor initiates searches using provided identifiers.

03

Results Reviewed

HR compares findings to role criteria and disclosure.

04

Decision Recorded

Hiring outcome and any adverse-action notices are logged.

Comparing eSignature vendors for Employment Criminal Declaration workflows

Key vendor differences include starting price, envelope or session limits, bulk-send capability, audit trails, and HIPAA support — choose a provider that matches your compliance needs.

	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	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Real-world examples of practical use

Two concise examples illustrate how organizations use the declaration in hiring and compliance workflows.

Case Study 1

A mid-size healthcare employer required a signed declaration during onboarding to document prior convictions

The HR team used conditional fields to capture details only when needed
This reduced manual follow-ups and ensured records were stored under the facility’s HIPAA retention schedule, improving audit readiness.

Case Study 2

A national retail chain included the declaration in the online application flow

Bulk send and automated routing reduced processing time
Results were routed to a screening vendor and HR for adjudication, enabling consistent decisions across locations.

Practical tips to complete and manage declarations accurately

Follow consistent policies and document controls to minimize risk and support fair, defensible hiring decisions.

Standardize questions

Use clear, job-relevant questions and defined lookback periods consistent with company policy and applicable law.

Separate consent

Capture a distinct consent checkbox for background checks and provide a consumer disclosure when required by ESIGN (15 U.S.C. ch. 96).

Authenticate signers

Select signer authentication commensurate with risk — email/SMS for low risk; stronger methods for sensitive roles.

Store securely

Apply role-based access, encryption, and a documented retention policy aligned with federal and state requirements.

Frequently asked questions about Employment Criminal Declarations

Answers to common questions on signing, consent, recordkeeping, and legal validity for both paper and electronic declarations.

Need help? Contact support

Can the declaration be signed electronically?
Yes. Electronic signatures are legally equivalent to handwritten signatures under the ESIGN Act (15 U.S.C. ch. 96) and state UETA laws when intent, consent, attribution, and reliable record retention are present.
Do applicants need a separate consent for background checks?
Yes. Employers should obtain a clear, stand-alone consent for criminal-history checks and provide any consumer disclosures required under the Fair Credit Reporting Act where a third-party consumer-reporting agency is used.
What if a signer disputes accuracy later?
Maintain the signed record, audit trail, and identity-verification artifacts; these support adjudication and demonstrate the employer’s reliance on the signer’s attestation during hiring decisions.
Are sealed or expunged records reportable?
State laws differ. Some jurisdictions allow disclosure of expunged or sealed records in limited contexts; employers should consult state law and legal counsel before requiring disclosure.
When is notarization required?
Notarization is uncommon for routine employment declarations but may be required for certain attestations in specific states or for executives; consult state notary rules when in doubt.
How long should I keep the signed declaration?
Retain for the active employment term plus at least 3 years, longer where industry rules apply (e.g., HIPAA six years or other state-specific periods).

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