Can an authorization be signed electronically?

Yes. Electronic signatures are legally valid under the ESIGN Act (15 U.S.C. §7001) and UETA (adopted by most states) when the signature demonstrates intent, the signer consents to electronic records, attribution is established, and a reproducible record exists.

Do I need a notarized authorization?

Generally no. Standard criminal history authorizations do not require notarization. Notarization or RON may be necessary only when state law or a specific vendor requires it for identity proofing or authentication.

What if the applicant’s name doesn’t match records?

Verify additional identifiers such as DOB and prior addresses. Mismatches should be resolved before taking adverse action to avoid relying on incorrect criminal history matches.

How do I handle sealed or expunged records?

Follow state law regarding sealed or expunged convictions; do not rely on or disclose sealed records if state law prohibits their use in employment decisions.

What notices are required before adverse action?

If you used a consumer reporting agency, provide a pre‑adverse action notice with a copy of the report and a summary of rights, then a final adverse‑action notice after the decision per FCRA procedures.

Can the authorization be revoked?

Applicants may withdraw consent for future searches, but revocation does not undo checks already completed. Document withdrawal and consult counsel on the legal effect before taking any employment action.

Electronic Signature
Templates
HR
Employment Criminal History Records

Employment Criminal History Records

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

EMPLOYMENT CRIMINAL HISTORY RECORDS

This form collects criminal history information and provides the employer with authorization to obtain criminal records and related information for employment purposes. Completion of this form is required for consideration and is subject to applicable laws governing background checks. Information provided will be used solely for assessing suitability for the position and will be maintained as confidential to the extent permitted by law.

Personal Information

Full legal name:

Other names used (maiden, aliases) Date of birth Last 4 digits of Social Security Number Driver's license or ID number and state Current address

Phone number

Email address

Position Information

Position applied for

Department

Reporting manager

Anticipated start date

Criminal History Disclosure

Have you ever been convicted of a criminal offense (felony or misdemeanor) in any jurisdiction?

Yes No

If yes, provide each offense below. Include offense, date, jurisdiction, final disposition, and sentence. Attach additional pages if necessary.

Offense 1 — Description

Offense 1 date

Jurisdiction / Court

Offense 1 disposition Offense 1 sentence or penalty Offense 2 — Description

Offense 2 date

Jurisdiction / Court

Offense 2 disposition Offense 2 sentence or penalty Offense 3 — Description

Offense 3 date

Jurisdiction / Court

Offense 3 disposition Offense 3 sentence or penalty

Additional Criminal History Information

Have you been arrested but not convicted for any offense that is relevant to the position?

Yes No

If yes, explain

Are any convictions sealed, expunged or otherwise subject to special confidentiality?

Yes No

If yes, provide identifying details

Authorization and Release

I authorize the prospective employer, its agents, and contracted screening providers to obtain and review any criminal justice records, court records, and related information concerning me. I expressly authorize any law enforcement agency, court, correctional facility, or other record custodian to release such records. I understand that the employer may consider the nature of any offense, recency, and relevance to the position when making hiring decisions.

I further release and hold harmless the employer and any person or entity furnishing information from any liability arising from the disclosure or use of such information for employment purposes, except to the extent prohibited by law. I understand that any willful misrepresentation or omission of material facts may constitute grounds for denial of employment or termination if employed.

I understand I may be required to submit fingerprints and consent to a fingerprint-based criminal history check where permitted by law. I acknowledge that receipt of criminal history information does not, by itself, constitute an adverse employment action; any adverse action will be based on a case-specific assessment and will comply with applicable legal requirements.

Employment History (most recent)

Employer 1 — Company name

Title

Dates employed

Primary responsibilities Reason for leaving Employer 2 — Company name

Title

Dates employed

Primary responsibilities Reason for leaving

Education

Highest degree or certification Institution Graduation date Major / Field of study

References

Reference 1 — Name

Phone

Email

Relationship Reference 2 — Name

Phone

Email

Relationship Reference 3 — Name

Phone

Email

Relationship

Legal Disclosures

At-Will Employment: If hired, either the employee or the employer may terminate the employment relationship at any time, with or without cause and with or without notice, unless a separate written agreement states otherwise and is executed by an authorized representative.

Equal Opportunity: The employer provides equal employment opportunities without regard to race, color, religion, sex, national origin, disability, age, or other protected classifications as required by law. Criminal history will be considered only insofar as it bears on the duties and responsibilities of the position and in accordance with applicable laws.

Applicant Certification and Consent

I certify that all statements on this form are true, complete, and correct to the best of my knowledge. I understand that falsification or omission of facts may result in denial of employment or termination. I authorize investigation of all statements contained in this form and understand that the employer may obtain criminal history records and other relevant information. I understand my rights to contest the accuracy of any report obtained about me and to provide additional information for consideration.

Applicant Name:

Signature:

Date:

What Employment Criminal History Records Are and when they’re used

Employment Criminal History Records are formal documents used by employers and background-screening providers to request, disclose, and record an applicant’s or employee’s criminal history information for hiring, placement, or security‑sensitive roles. These records typically combine an applicant consent/authorization, identity data, the scope of checks requested (local, state, national, sex offender registry), and a statement of consumer rights where a third‑party consumer reporting agency (CRA) is used. Employers must use these forms consistent with federal and state laws, including the Fair Credit Reporting Act for CRA‑based checks and ESIGN/UETA when executed electronically.

Why a complete and compliant record matters

A properly completed Employment Criminal History Record documents consent, scope, and identity so employers meet legal disclosure requirements and reduce hiring risk. Clear records help defensibly demonstrate compliance with consumer reporting, privacy, and non‑discrimination obligations while providing an audit trail for adverse‑action processes.

Who prepares and who signs this record

Employers, HR teams, hiring managers, background screening vendors, and applicants commonly handle Employment Criminal History Records; each party has specific responsibilities during completion.

Human resources specialists: Draft the scope, obtain consent, manage CRA submissions, and track adverse action timelines.
Background screening providers: Verify identity, run searches, return reports, and supply required consumer disclosure language where applicable.
Applicants and employees: Provide accurate identity information and sign the authorization and disclosure components prior to screening.

Keep distribution limited to authorized HR personnel and CRAs; store completed records securely and retain them according to regulatory and corporate retention policies.

Common signers and approvers

HR Manager

An HR Manager signs to certify the job role, scope of the checks, and that pre‑employment disclosures were provided. They are responsible for tracking adverse action steps and ensuring compliance with applicable state and federal rules.

Applicant / Employee

The applicant provides name, DOB, address, and signature consenting to the background check. Their signed authorization must match identity documents and include clear consumer disclosure language if a CRA will prepare the report.

Core elements included in a professional Employment Criminal History Record

A compliant record combines identity verification, consumer disclosure (if used), scope and duration, signature and date, and storage notes to support later review or adverse‑action steps.

Applicant Identity

Full legal name, date of birth, current and prior addresses, and a government ID reference to ensure searches match the correct subject and reduce false matches.

Scope of Search

Specify jurisdictions and databases to be searched (county criminal records, state repository, national index, sex offender registry) and any exclusions such as sealed or expunged records.

Consumer Disclosure

When a CRA is used, include a clear standalone disclosure and separate written authorization meeting FCRA requirements and describing the applicant's rights.

Signature & Date

Signature block for the applicant plus date and signer role. Electronic signatures are acceptable under ESIGN and UETA when intent, consent, attribution, and retention are satisfied.

Purpose and Position

State the specific hiring purpose and the job title or function tied to the background check to justify scope and demonstrate nondiscriminatory intent.

Retention and Access

Record who may access the file, how long it will be kept, and the process for correcting inaccuracies or disputing a report.

Step‑by‑step: completing an Employment Criminal History Record

Follow a consistent sequence to collect information, confirm identity, obtain consent, and submit searches to ensure legal and procedural compliance.

01

Collect identity: Record full name, DOB, and address to match search targets.
02

Provide disclosure: Deliver standalone CRA disclosure if a consumer report will be ordered.
03

Obtain signature: Get a dated signature or valid eSignature showing intent to sign.
04

Submit to CRA: Send the authorization and identity info to your screening vendor for searches.

Typical digital workflow settings for eSubmission

Configure form fields and signer authentication to match your risk profile and applicable legal requirements before sending electronically.

Field	Configuration
Authentication level	Email link or SMS code; use stronger KBA for high‑risk roles
Signature capture	Enable typed, drawn, or image signatures; ensure audit trail enabled
Conditional fields	Show scope options based on job role to avoid overbroad searches
Record retention	Set automatic archival and access controls per retention policy

Typical processing flow for an electronic background authorization

Electronic workflows should preserve evidence of intent, identity, and access while routing documents to screening vendors and HR with an audit trail.

Upload form: Sender uploads the authorization and populates fields.
Place fields: Assign signature, date, and identity fields for signer.
Signer authenticates: Signer receives link and completes authentication step.
Send to CRA: Signed authorization and data forwarded to the background vendor.

Technology considerations for eSigning and storage

Choose a platform that supports auditable signing, secure storage, and the authentication levels your policy requires.

File formats: PDF and DOCX support for archival and vendor compatibility
Integrations: Connectors available for HRIS, ATS, and cloud storage
Security: Encryption in transit and at rest, role‑based access

Timing considerations and important deadlines

Adverse‑action and notification timelines are time‑sensitive; follow FCRA and internal policies for decision windows and communications.

Pre‑employment disclosure:

Provide standalone disclosure and authorization before ordering a consumer report.

Pre‑adverse action:

Supply a copy of the consumer report and summary of rights before final adverse action.

Adverse action:

Issue a final adverse‑action notice after the decision with required contact details.

Record retention schedule:

Retain authorizations and notices per corporate retention policy and applicable law.

Dispute handling:

Allow the CRA and applicant time to investigate disputes per the FCRA

Key milestones from request to decision

Track milestones to ensure legal timing and a defensible hiring process.

01

Request Authorization

Collect completed consent and identity verification before ordering searches.

02

Run Background Checks

Background vendor performs searches and delivers a report.

03

Pre‑Adverse Action Notice

Share report and summary of rights before final adverse action.

04

Final Decision & Notice

Issue adverse or hiring notice and archive records per retention rules.

Common mistakes that cause delays or legal exposure

Using a combined disclosure and authorization that fails to meet standalone consumer disclosure requirements under FCRA can invalidate steps for CRA‑based checks.
Collecting inconsistent identity information (e.g., name or DOB mismatches) produces false matches and slows investigations or triggers incorrect adverse actions.
Overbroad searches without job‑related justification increase discrimination risk and public‑policy scrutiny in jurisdictions with ‘ban the box’ or similar restrictions.
Failing to retain the audit trail or signed authorization makes it harder to defend timely notice and compliance in litigation or regulatory review.

Penalties and legal risks of incorrect or missing records

FCRA Violations: Civil damages and statutory penalties for failure to follow CRA procedures.

Discrimination Claims: EEOC exposure if background screening results in disparate impact discrimination.

State Penalties: Fines or corrective orders where state law limits use of certain convictions or arrests.

Data Breach Liability: Costs and penalties from unsecured personal data disclosure.

Operational Delays: Hiring bottlenecks and lost productivity from incomplete authorizations.

Invalid Adverse Action: Failure to provide required notices can void adverse decisions and increase litigation risk.

Security and compliance controls to protect sensitive records

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

Access Controls: Role‑based permissions and audit logging

BAA Availability: Business associate agreement required for protected health information

Audit Trail: Timestamped signer events and IP capture

Certifications: SOC 2 Type II and ISO 27001 support

Retention Controls: Automated archival and secure deletion

eSignature vendor comparison for Employment Criminal History Records workflows

Compare core pricing and compliance features when selecting an eSignature provider for background authorizations; signNow is listed first for reference.

	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	Varies	Varies	Varies
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Practical examples of how organizations use these records

Real‑world scenarios show how form design and workflow choices affect compliance and hiring speed.

Retail chain

A regional retail chain standardized a short authorization on hiring portals for hourly staff to reduce time to offer by three days.

They limited searches to state and county where the applicant lived.
The change lowered turnaround time and improved documentation for adverse‑action decisions while maintaining compliance.

Community health center

A health center integrated a HIPAA‑aware authorization with its EHR workflow to screen clinical hires quickly.

They used role‑based scope to avoid unnecessary national searches.
This approach preserved patient privacy, reduced vendor costs, and provided a clear audit trail for credentialing.

Frequently asked questions and common troubleshooting

Answers to common questions on eSigning, legal validity, and correcting or revoking Employment Criminal History Records.

Need help? Contact support

Can an authorization be signed electronically?
Yes. Electronic signatures are legally valid under the ESIGN Act (15 U.S.C. §7001) and UETA (adopted by most states) when the signature demonstrates intent, the signer consents to electronic records, attribution is established, and a reproducible record exists.
Do I need a notarized authorization?
Generally no. Standard criminal history authorizations do not require notarization. Notarization or RON may be necessary only when state law or a specific vendor requires it for identity proofing or authentication.
What if the applicant’s name doesn’t match records?
Verify additional identifiers such as DOB and prior addresses. Mismatches should be resolved before taking adverse action to avoid relying on incorrect criminal history matches.
How do I handle sealed or expunged records?
Follow state law regarding sealed or expunged convictions; do not rely on or disclose sealed records if state law prohibits their use in employment decisions.
What notices are required before adverse action?
If you used a consumer reporting agency, provide a pre‑adverse action notice with a copy of the report and a summary of rights, then a final adverse‑action notice after the decision per FCRA procedures.
Can the authorization be revoked?
Applicants may withdraw consent for future searches, but revocation does not undo checks already completed. Document withdrawal and consult counsel on the legal effect before taking any employment action.

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