Establishing secure connection…Loading editor…Preparing document…

Employment Police Check Form

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

EMPLOYMENT POLICE CHECK FORM

Personal Information

Date of Birth:

Place of Birth:

Gender:

Telephone:

Email:

Government ID (type & number):

Previous Addresses (Last 7 Years)

Position Information

Department:

Reporting Manager:

Requested Start Date:

Proposed Salary / Rate:

Employment History (Most Recent First)

Title:

Dates Employed: From To

Phone:

Title:

Dates Employed: From To

Phone:

Education

Graduation / Completion Date:

Professional References (3)

Phone:

Email:

Phone:

Email:

Phone:

Email:

Criminal History Disclosure

Have you ever been convicted of, or pled guilty or no contest to, a criminal offense (felony or misdemeanor)? Check one and provide details if applicable.

Authorization for Police / Background Check

I authorize the employer and its designated representatives to obtain police records, criminal history checks, fingerprint-based checks, and other investigative reports for employment purposes. I understand that these checks may include local, state/provincial, and national records where authorized by law. I authorize all persons, schools, current and former employers, law enforcement agencies, and other organizations to release requested information.

I release from liability the employer and any person or entity that provides information in good faith pursuant to this authorization. I understand that a conviction will not automatically disqualify me, but may be considered in relation to the duties and responsibilities of the position.

Legal Disclosures and Applicant Certification

At-Will Employment: If employed, I acknowledge that my employment relationship is at-will, meaning that either I or the employer may terminate employment at any time, with or without cause or notice, unless otherwise provided in a signed written agreement.

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

Certification: I certify that all information provided on this form is true, complete, and correct to the best of my knowledge. I understand that falsification, misrepresentation, or omission of information may result in refusal to hire, withdrawal of an offer, or discipline, up to and including termination.

I understand that information obtained through police checks will be used only for employment-related decisions and stored in accordance with applicable retention policies. I understand that I may be required to provide additional identifying information, such as fingerprints, to complete the required checks.

Applicant:

Signature:

Date:

Enter text✕
Prepare your document for signing right on this page
  • 01 Edit the text and complete the fields
  • 02 Click Sign Now and on the next screen add recipients and signature fields in SignNow
  • 03 Start your free trial to sign and send your doc
Sign Now

What the Employment Police Check Form Is and when it’s used

The Employment Police Check Form is a written consent and information collection document employers use to request a criminal records check as part of pre-employment screening or periodic re‑checks. It captures applicant identifiers, contact details, and scope of the check, and documents the applicant's consent to obtain local, state, and national criminal history records. The form supports compliance with the Fair Credit Reporting Act when third‑party background check vendors are used and records the date and signature that authorize the search.

Why a clear, compliant form matters for hiring

A properly completed Employment Police Check Form documents consent, reduces legal risk, and speeds vendor processing. Clear fields minimize errors that delay results and increase the chance the check meets FCRA and state privacy requirements.

Why a clear, compliant form matters for hiring

Typical users and where this form fits in hiring workflows

Employers and HR teams preparing to screen candidates use this form before ordering a background report.

  • Small and mid‑size employers conducting pre‑hire background checks for regulated roles.
  • Large HR teams integrating vendor checks into onboarding and periodic rechecks.
  • Third‑party background screening firms collecting applicant consent and identifiers.

Use the form as part of the application, offer acceptance, or rehire process and keep a signed copy for your records.

Essential parts of a professional Employment Police Check Form

A compliant form balances clear identification fields, explicit consent language, disclosure of scope, and a signer authentication block to create an auditable record for employers and vendors.

Applicant ID

Full legal name, aliases, date of birth, and place of birth to help match records and reduce false positives during searches.

Contact Details

Current address, previous addresses for at least seven years, phone number, and email to locate jurisdictional records and support vendor follow‑up.

Government IDs

Driver license number, state of issuance, and social security number (or last four) when required; helps verify identity and improve search accuracy.

Consent Language

Clear authorization that permits local, state, and national criminal records checks and explains whether the report may include arrests, convictions, and sex offender registry data.

Disclosure Notice

When a consumer reporting agency is used, include the FCRA pre‑adverse/adverse action language and describe applicant rights under the FCRA.

Signature Block

Typed or handwritten signature, printed name, date, and signer role; include witness or notarization lines only when state law requires them.

Step-by-step: completing the Employment Police Check Form

Follow these four steps in order to collect valid consent and send the request to a screening vendor or law enforcement agency.

  • 01
    Collect identifiers: Obtain full name, DOB, SSN/last four, and current address.
  • 02
    Explain scope: Tell the applicant which records will be searched and why.
  • 03
    Obtain consent: Confirm the applicant signs and dates the consent section.
  • 04
    Send to vendor: Upload form and attachments to vendor or submit to local agency.

How to set up a digital workflow for police check requests

Configure your online workflow to capture identity, verify consent, and route signed forms to HR and the screening vendor.

Field Configuration
Authentication Email link with optional SMS OTP for higher assurance
Signature Type Allow typed signature or drawn signature on mobile
Attachments Require government ID upload (JPEG or PDF)
Routing Send signed copy to HR and vendor automatically

Typical submission flow after the form is signed

This reflects standard routing: collect, verify, submit, then store. Adjust steps to match vendor requirements and state rules.

  • Collect: Applicant completes and signs the form online or on paper.
  • Verify: HR confirms identity and required attachments are present.
  • Submit: Upload to the vendor portal or send to the local police records office.
  • Store: Store signed form in secure HR records with access logging.

Digital signing and submission considerations

Confirm your eSignature platform supports audit trails, secure uploads, and role-based routing before collecting consent.

  • Authentication Options: Email, SMS, or KBA
  • File Formats: PDF, DOCX accepted
  • Integrations: HRIS, background vendor APIs

Ensure the platform can retain a reproducible record of the signed form (audit trail, timestamp, signer IP) to meet legal and vendor requirements.

Timelines and typical processing expectations

Expect variations by vendor and jurisdiction. These entries reflect common timeframes and critical timing rules to track.

Pre‑check Consent:

Obtain signed consent before running a background search

Vendor Turnaround:

Most reports return in 2–7 business days depending on jurisdictions searched

Adverse Action Timing:

If adverse action is possible, provide pre‑adverse notice and a copy of the report before final action

Correction Window:

Applicants may dispute and request reinvestigation; allow 30 days for vendor response

Record Retention:

Retain signed consent per company policy and applicable records retention laws

Key milestones from consent to completed check

Track each milestone to ensure compliance and timely hiring decisions.

01

Consent Received

Signed authorization is captured and timestamped.

02

Background Ordered

Vendor receives form and begins multi‑jurisdiction searches.

03

Report Delivered

Vendor returns a compiled report to HR.

04

Decision & Notice

Employer documents outcome and issues any required notices.

Common mistakes that delay or invalidate checks

  • Incomplete identifiers lead to mismatches and false positives, requiring repeat searches.
  • Missing explicit consent before ordering a report violates FCRA procedures when a CRA is used.
  • Using an unsecured channel to transmit SSNs increases privacy and breach risk.
  • Failing to keep an audit trail impedes defending hiring decisions in disputes.

Key legal risks and potential penalties to watch

FCRA Liability: Civil and statutory damages (15 U.S.C. §1681n)
Discrimination Risk: Adverse action claims under EEOC guidance
Privacy Violations: State data privacy fines and consumer claims
Breach Exposure: Costs from leaked SSNs and identity data
Incorrect Disposal: Sanctions for improper record retention
Criminal Penalties: Rare, for intentional misuse of sensitive records

Required data elements and minimal retention notes

Full Name: Applicant's legal name
Date of Birth: MM/DD/YYYY
SSN / Last4: Full SSN or last four digits
Addresses: Current and prior addresses
ID Numbers: Driver license or state ID
Signed Consent: Signed and dated authorization

How organizations use electronic forms and eSignature in screening

These examples illustrate how digital authorization and secure eSignature streamline screening and recordkeeping across industries.

Fertility Centers of Illinois

They centralized authorization forms into a single digital workflow to reduce manual handling and missing signatures.

  • The team used mobile signing for quick candidate completion.
  • John Butler, Founder, said the API and responsiveness helped enforce security and compliance while accelerating onboarding across clinics.

Martin Properties

Property management switched to online consent capture to speed tenant and contractor checks.

  • Mobile and offline signing handled onsite applicants.
  • Tim Martin, Founder, noted that executing forms online delivered compliance and efficiency for high-volume seasonal hiring needs.

Comparing eSignature vendor pricing and basic features for police check workflows

Vendors differ on starting price, enterprise options, and whether HIPAA support or bulk sending is included. signNow is listed first for direct comparison.

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 (Premium) Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes (BAA) Yes Yes No No

FAQs and troubleshooting for Employment Police Check Forms

Answers to common questions about consent, eSignature validity, corrections, and result handling when using police check forms.


Need help? Contact support

be ready to get more
Join over 28 million airSlate SignNow users
Sign Now
Company
Forms
Pricing
Resources
Knowledge base
Other Products
© 2026 airSlate Inc. All rights reserved.