Can the form be signed electronically?

Yes. Electronic signatures are valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA in most states where adopted; ensure intent, consent, attribution, and reliable record retention to meet the legal-validity test.

Do you need notarization or witnesses?

Generally no for routine employment screening forms, but state or employer-specific rules can require notarization or witnesses for certain affidavits. Verify local notary and RON rules before adding a notarization requirement.

What if an applicant disputes the record?

Retain copies of supporting court records and the signed consent. If the dispute involves a consumer report, follow FCRA procedures for reinvestigation and disclosure of results where applicable.

How long must records be kept?

Follow federal minimums (e.g., IRS 3 years, HIPAA 6 years where applicable, I-9 retention rules at 8 CFR §274a.2) and extend retention per state or industry-specific requirements.

Who should sign the form on behalf of the employer?

An authorized HR representative or hiring manager typically signs for employer acknowledgment. Document signatory authority in internal policy and maintain role-based access controls.

How to correct a completed form?

Do not alter original records. Have the signer complete an amendment or supplemental form that identifies the correction, provides the new information, and is dated and signed to preserve an auditable history.

Electronic Signature
Templates
HR
Employment Felony Offender Info Form

Employment Felony Offender Info Form

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

EMPLOYMENT FELONY OFFENDER INFORMATION FORM

Personal Information

Full legal name:

Date of birth:

Address Phone Email

Position Information

Position Applied For Department Reporting Manager (if known)

Desired start date:

Salary or wage expected

Employment History (Most Recent)

Employer 1 — Company Title / Position

Dates employed:

Primary responsibilities Reason for leaving

Employment History (Previous)

Employer 2 — Company Title / Position

Dates employed:

Primary responsibilities Reason for leaving

Education

Highest Degree or Diploma Institution

Graduation date:

Professional References

Reference 1 Reference 2 Reference 3

Felony and Criminal History Disclosure

Have you ever been convicted of a felony? Are there any pending criminal charges against you?

If yes to either question above, complete the fields below. Provide full details for each matter; attach additional pages if necessary.

Offense / Charge

Date of conviction or charge: Jurisdiction (court / county / state):

Disposition / Sentence

Sentence completion or release date: Currently on probation or parole?

Has the conviction been expunged or sealed?

Explanation and Rehabilitation Information Supporting documentation included

Authorizations and Disclosures

I authorize the employer to investigate and verify the accuracy of the information provided in this form and any other employment application materials. This authorization includes, but is not limited to, criminal history checks, verification of prior employment, education, and professional references, to the extent permitted by law.

I understand that the existence of a conviction does not automatically disqualify me from employment; any determination will be based on the nature and gravity of the offense, the time that has elapsed, and the nature of the position sought. I further understand that failure to disclose required information, or providing false or misleading information, is grounds for denial of employment or, if employed, disciplinary action up to termination.

Authorization for background investigation: Authorization to contact prior employers: Authorization to contact references:

Legal Notices

At-will employment: If employed, I understand that my employment is at-will, which means either I or the employer may terminate the employment relationship at any time, with or without cause or notice, unless a separate written agreement states otherwise and is signed by an authorized representative of the employer.

Equal opportunity: The employer evaluates applicants without regard to protected characteristics and will consider criminal history in accordance with applicable law and business necessity. The information I provide will be considered only to the extent permitted by law in relation to the duties of the position.

Applicant Certification

I certify that all information provided in this form and any attachments is true, complete, and correct to the best of my knowledge. I authorize the release of information to the employer and its agents for the purpose of evaluating my application. I understand that any misrepresentation, omission, or falsification may disqualify me from employment or may result in termination if discovered after hire.

Printed name:

Signature:

Date:

What the Employment Felony Offender Info Form Is

The Employment Felony Offender Info Form is a standardized employer document used to collect factual information about an applicant or employee with a felony conviction. It captures identifying details, conviction summary, jurisdiction and dates, consent to background checks, and any supporting documentation employers need to evaluate suitability for a role while documenting a consistent hiring decision process. The form is intended for use with background screening, reasonable-risk assessments, and retention in personnel files subject to applicable recordkeeping rules and nondiscrimination laws. Electronic completion and signatures are acceptable under federal e-signature law when requirements are met.

Why a Standardized Form Matters for Employers

A consistent Employment Felony Offender Info Form reduces ambiguity in hiring decisions, creates an auditable record for compliance and defensibility, and helps employers apply consistent criteria when evaluating criminal history. It supports fair-chance policies, documentation for adverse-action processes, and evidence of informed decision-making.

Who Typically Completes or Reviews This Form

Employers use this form as part of hiring, onboarding, or internal review workflows to document convictions and the related facts needed for informed decisions.

HR managers or recruiters responsible for applicant screening and recordkeeping.
Compliance officers documenting nondiscrimination review and adverse-action rationale.
Background screening vendors and legal counsel verifying conviction details.

The form also serves as a standard record for compliance teams, auditors, and external background screening providers when lawfully engaged.

Typical Signatories and Their Roles

HR Manager

HR managers collect the completed form, confirm identity documents, and document the hiring decision. They ensure the record follows company policy and applicable laws such as fair-chance statutes, and they maintain secure storage and retention consistent with personnel-file requirements.

Background Vendor

Background screening providers receive applicant consent via this form, perform public-record checks, and return verified conviction data. They supply documentation used in adverse-action steps and must comply with the Fair Credit Reporting Act when applicable.

Security and Compliance Essentials

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

Access Controls: Role-based access, least privilege

Audit Trail: Detailed signing timestamps and IPs

HIPAA-ready: BAA available where PHI present

ESIGN / UETA: Compliant e-signature frameworks

Authentication: SMS, email, or stronger options

Principal Risks of Incorrect or Incomplete Forms

I-9 Penalties: I-9 fines $281–$2,789

Privacy Fines: State data breach penalties vary

Discrimination Claims: Adverse-action exposures increase

FCRA Violations: Liability for improper disclosures

Civil Liability: Wrongful-hire or defamation suits

Recordkeeping Failures: Regulatory audit findings possible

Common Preparation Errors to Avoid

Incomplete identity data: missing or inconsistent legal names, DOBs, or ID numbers cause verification failures and delay screening.
Vague conviction descriptions: failing to include statute, jurisdiction, or disposition creates ambiguity for adjudicators and background vendors.
Missing consent language: not obtaining explicit written consent for background checks can violate FCRA and state screening rules.
Improper storage or sharing: unsecured transmission of conviction details increases privacy risk and potential regulatory exposure.

How to Complete the Employment Felony Offender Info Form

Follow these sequential steps to collect, verify, and store conviction information in a way that supports compliance and fair assessment.

01

Gather documents: Collect ID, court records, and disposition documents.
02

Complete form: Enter details, dates, jurisdiction, and supporting notes.
03

Obtain consent: Get explicit written consent for background checks.
04

Verify and store: Confirm records, document decision, and secure file.

Typical Processing Flow for the Form

This describes the usual routing from collection to decision and archival when using digital or paper workflows.

Upload or attach: Place the completed form in the applicant file or e-system.
Assign reviewer: Route to HR or compliance for assessment.
Complete checks: Run background checks and confirm court records.
Make decision: Record hiring outcome and any adverse-action steps.

Core Sections to Include on a Professional Form

A well-structured Employment Felony Offender Info Form groups information into clear sections so reviewers can find facts quickly and support defensible hiring decisions.

Applicant Details

Full legal name, aliases, date of birth, contact information, and government ID references to uniquely identify the person and avoid mismatches.

Conviction Summary

Short factual description of the offense, statute citation, conviction date, and sentence or disposition to provide context for adjudication.

Jurisdiction

State and county of conviction and the court of record to enable precise verification by background screening services or counsel.

Disposition and Dates

Entry and completion dates, whether the sentence was suspended, sealed, expunged, or otherwise altered by court action.

Consent and Acknowledgment

Clear consent for background checks and a statement the applicant provided accurate information, signed and dated per ESIGN/UETA requirements.

Supporting Documents

Space to attach court records, certificates of disposition, or rehabilitation documents that materially affect evaluation of fitness.

Practical Tips for Accurate and Defensible Completion

Adopt consistent practices across hiring teams to reduce legal risk and improve decision quality when reviewing conviction information.

Use consistent identity verification

Always match the applicant's full legal name and DOB to government-issued ID and court records. Flag aliases and verify via original court filings to prevent mistaken identity and ensure the conviction record corresponds to the correct person.

Limit and document questions

Ask only job-related conviction questions and record the business rationale for inclusion. Document how the conviction is relevant to essential job duties to support a consistent, nondiscriminatory assessment under fair-chance or Title VII considerations.

Obtain clear written consent

Use explicit language authorizing background checks and explain consumer rights where the Fair Credit Reporting Act applies. Keep a copy of the signed consent to support lawful disclosure and adverse-action procedures.

Train decision-makers

Provide HR and hiring managers with instruction on interpreting court dispositions, understanding expungement or sealing, and following company policies that align with state and federal law to reduce arbitrary or biased decisions.

Key Processing Milestones for Each Submission

Track milestones to ensure timely verification, decision-making, and record retention for each form received.

01

Submission received

Form and documents are uploaded and acknowledged by HR.

02

Verification completed

Background vendor or HR confirms records.

03

Decision window

Adjudication and hiring decision documented.

04

Archive and retention

Record stored according to retention policy.

Timing Expectations and Common Deadlines

Typical timelines help set expectations for applicants, background vendors, and hiring teams.

Background check turnaround:

Allow 3–7 business days for standard public-record checks, longer for complex jurisdictional searches.

Adverse-action notification:

Provide required notices promptly after a negative decision following FCRA procedures where applicable.

Form updates:

Request clarifications or new documents within a reasonable period, typically 5–10 business days.

Record access requests:

Respond to applicant requests per state law and company policy within the statutory timeframes.

Retention review:

Conduct periodic reviews to purge or archive records according to retention policy.

Configuring an Online Form Workflow

When implementing the form online, configure fields, authentication, and routing to match internal review processes and legal requirements.

Field	Configuration
Auto-detect fields	Use platform magic fields to auto-place name, date, signature.
Conditional logic	Show conviction-detail fields only when applicable to reduce clutter.
Required signature	Mark consent and signature fields as mandatory before submission.
Authentication method	Choose email, SMS, or stronger ID verification for signer identity.

Technical Considerations for Digital Use

Digital handling requires secure formats, auditable trails, and integration with HR systems to streamline review and retention.

Integrations: Connects to HRIS and background vendors.
Supported formats: PDF, DOCX, and fillable form exports.
Authentication options: Email, SMS, KBA, or enterprise SSO.

eSignature Vendor Pricing and Capability Snapshot

Compare common eSignature options and basic capability availability; signNow is listed first in the comparison per platform guidance.

	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	Yes	Yes	Yes	Yes
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

Frequently Asked Questions About the Form

Answers to common questions on e-signatures, legality, notarization, corrections, and retention for the Employment Felony Offender Info Form.

Need help? Contact support

Can the form be signed electronically?
Yes. Electronic signatures are valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA in most states where adopted; ensure intent, consent, attribution, and reliable record retention to meet the legal-validity test.
Do you need notarization or witnesses?
Generally no for routine employment screening forms, but state or employer-specific rules can require notarization or witnesses for certain affidavits. Verify local notary and RON rules before adding a notarization requirement.
What if an applicant disputes the record?
Retain copies of supporting court records and the signed consent. If the dispute involves a consumer report, follow FCRA procedures for reinvestigation and disclosure of results where applicable.
How long must records be kept?
Follow federal minimums (e.g., IRS 3 years, HIPAA 6 years where applicable, I-9 retention rules at 8 CFR §274a.2) and extend retention per state or industry-specific requirements.
Who should sign the form on behalf of the employer?
An authorized HR representative or hiring manager typically signs for employer acknowledgment. Document signatory authority in internal policy and maintain role-based access controls.
How to correct a completed form?
Do not alter original records. Have the signer complete an amendment or supplemental form that identifies the correction, provides the new information, and is dated and signed to preserve an auditable history.

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