Can this form be signed electronically?

Yes. Electronic signatures are enforceable under the ESIGN Act (15 U.S.C. §7001) and UETA in adopted states, provided the four-element test of intent, consent, attribution, and record retention is satisfied.

When is an FCRA disclosure required?

An FCRA disclosure and separate written authorization are required whenever a consumer reporting agency provides a consumer report for employment or credit decisions (see FCRA, 15 U.S.C. §1681 et seq.).

How do I revoke or withdraw consent?

Revocation must be documented in writing; processing may depend on vendor policies and timing. Maintain clear records of any withdrawal and cease future checks absent lawful basis.

Is notarization ever required?

Not typically for standard releases, but state-specific documents or affidavits can require notarization or witnesses. Check local rules before adding notary fields.

What if the applicant disputes report accuracy?

Follow FCRA dispute procedures: allow the consumer to dispute directly with the reporting agency and pause adverse actions until the dispute is resolved if applicable.

How long should I keep signed releases?

Retain signed releases for the active purpose plus at least three years; follow industry rules such as HIPAA six-year retention for PHI and consider a seven-year post-termination retention policy for defense.

Electronic Signature
Templates
Legal
History Check Release Form

History Check Release Form

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

HISTORY CHECK RELEASE FORM

This History Check Release Form (the "Release") is made and entered into by and between Requesting Party: and Applicant: effective as of .

RECITALS

WHEREAS, Requesting Party requires certain background information regarding Applicant in connection with Applicant's application for employment, volunteer service, licensing or other engagement with Requesting Party; and

WHEREAS, Applicant is willing to provide consent and information necessary for Requesting Party to obtain records, verify information and perform a history check, subject to the terms set forth below; and

WHEREAS, the parties desire to set forth the scope, authorization, limitations and assurances related to the history check and use of any resulting information.

NOW THEREFORE, in consideration of the mutual promises contained herein and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the parties agree as follows:

1. AUTHORIZATION

Applicant hereby authorizes Requesting Party, its agents, contractors and designated screening providers to obtain and review consumer reports, investigative consumer reports, public records, criminal history, motor vehicle records, education and employment verifications, professional license verifications, credit reports (if expressly authorized below), and any other records or information reasonably related to Applicant's background as permitted by applicable law (collectively, "History Information"). This authorization is a continuing one and covers any History Information obtained in connection with decisions to hire, retain, place, promote, or otherwise engage Applicant.

2. SCOPE OF CHECK

The specific background checks authorized by Applicant include (check all that apply):

Criminal history and public records Sex offender registry Motor vehicle and driving records Employment verification Education and credential verification Credit report (applicant consents) Professional license verification Fingerprinting and biometric checks

3. APPLICANT INFORMATION

Full Legal Name

Date of Birth:

Place of Birth:

Current Address Social Security Number (last four digits or full if required)

4. CONSENT TO OBTAIN RECORDS

Applicant expressly consents to the procurement, use and disclosure of History Information by Requesting Party and its agents for the purpose stated herein. Applicant further consents to the release of records and information by schools, employers, law enforcement agencies, courts, motor vehicle departments, credit bureaus, licensing boards and other entities to Requesting Party or its authorized agents.

5. USE, DISCLOSURE AND LIMITATIONS

Requesting Party may use History Information in making eligibility, hiring, retention, placement, licensing or disciplinary decisions. Requesting Party will limit access to History Information to individuals with a legitimate need to know. Any adverse action taken or contemplated on the basis of a consumer report will be communicated to Applicant in accordance with applicable law and Applicant will be provided an opportunity to review and dispute inaccurate information.

6. REPRESENTATIONS AND WARRANTIES

Applicant represents and warrants that all information supplied to Requesting Party in connection with this Release is true, complete and correct to the best of Applicant's knowledge. Applicant acknowledges that knowingly providing false information may be grounds for denial of appointment, termination of employment or other appropriate action.

7. RELEASE AND INDEMNIFICATION

To the fullest extent permitted by law, Applicant releases and discharges Requesting Party, its employees, agents, contractors and any information source for any liability arising from the obtaining, reporting or use of History Information, except for willful misconduct or violations of law. Applicant agrees to indemnify and hold harmless Requesting Party from and against any claims, losses or damages arising from Applicant's breach of this Release or misrepresentations made herein.

8. CONFIDENTIALITY, RETENTION AND DESTRUCTION

Requesting Party will treat History Information as confidential and will retain and destroy such information in accordance with its records retention policy and applicable law. Notwithstanding the foregoing, Requesting Party may retain a record of the decision and the report summary as required or permitted by law.

9. NOTICES

Any notice required or permitted under this Release shall be in writing and delivered to the address provided by each party in this form. Notice is effective upon personal delivery or three (3) days after deposit in the United States mail, postage prepaid, addressed as provided herein.

10. AMENDMENT; WAIVER; COUNTERPARTS

This Release may be amended only by a written instrument executed by both parties. A waiver of any provision or breach shall not constitute a waiver of any other provision or subsequent breach. This Release may be executed in counterparts and facsimile or electronic signatures shall be effective as originals.

11. GOVERNING LAW

This Release shall be governed by and construed in accordance with the laws of the state or jurisdiction in which Requesting Party principally operates, without regard to conflict of law principles.

12. ENTIRE AGREEMENT

This Release constitutes the entire agreement between the parties with respect to the subject matter herein and supersedes all prior agreements, understandings and representations, whether written or oral.

13. SEVERABILITY

If any provision of this Release is held to be invalid or unenforceable, such provision shall be severed and the remaining provisions shall remain in full force and effect.

14. ADDITIONAL ACKNOWLEDGMENTS

Applicant acknowledges receipt of a copy of this Release and understands that Applicant has the right to request a copy of any consumer report obtained and to dispute the accuracy of the information contained therein pursuant to applicable law.

Additional Instructions or Limitations (if any)

CERTIFICATION

By signing below, Applicant certifies under penalty of perjury that the information provided in this Release is true and correct, that Applicant authorizes the release and use of History Information as described above, and that Applicant has read, understands, and agrees to the terms and conditions of this Release.

Requesting Party (Printed Name):

Company/Entity:

By:

Date:

Position/Title:

Applicant (Printed Name):

Name:

Signature:

Date:

Telephone:

What a History Check Release Form Is and When it’s Used

A History Check Release Form is a written authorization that permits an employer, landlord, volunteer organization, or other requester to obtain a consumer report or background information about an individual. It typically documents the applicant’s consent for criminal background checks, employment verification, education checks, and credit or motor vehicle records when permitted. The form clarifies the scope of searches, specifies the requesting party, and confirms that the requester will comply with applicable laws such as the Fair Credit Reporting Act (FCRA) when a consumer reporting agency is involved. Properly completed releases reduce legal risk and support auditability.

Why a Clear Release Form Matters

A well-drafted History Check Release Form documents consent, establishes permissible scope, and creates an audit trail to demonstrate legal compliance for screening decisions. It protects both requesters and applicants by clarifying expectations, reducing disputes, and supporting defensible hiring or placement determinations under federal and state rules.

Who Typically Completes a History Check Release Form

Organizations and individuals that screen candidates, tenants, volunteers, or contractors commonly use this form before ordering background checks.

Employers screening hires for roles with safety or financial responsibilities.
Landlords and property managers verifying tenant histories and rental eligibility.
Volunteer organizations and schools checking suitability for work with vulnerable populations.

The requester should keep a signed copy and provide any consumer disclosures required by federal law when third-party consumer reporting agencies are used.

Primary roles involved

Hiring Manager

A hiring manager requests the report, verifies that the release describes the searches to be performed, and ensures FCRA disclosure/consent procedures are followed when consumer reports are used.

Background Vendor

A background screening provider receives the release as authorization, runs permissible searches, returns results, and supplies required adverse-action notices if the information influences decisions.

Core Elements to Include in the Form

A complete History Check Release Form balances clarity for the applicant with specific authorizations for the requester. Include plain-language items that establish legal permissibility, data scope, and procedural steps for adverse actions.

Parties

Names of the requester and the individual authorizing the check, including contact details.

Scope

Explicit list of checks authorized (criminal, credit, employment, education, motor vehicle).

Purpose

Business reason for the check (employment, tenancy, volunteer placement, licensing).

Consent

Clear statement the applicant consents to the specified searches and sharing of results.

FCRA Notice

Where applicable, a standalone consumer disclosure and authorization conforming to FCRA requirements.

Signature Block

Signature, printed name, date, and any witness or notary fields required by state law.

Step-by-step: Completing a History Check Release

Follow these sequential steps to collect valid consent and submit the request to a screening provider or internal HR team.

01

Prepare Form: Select a template that includes FCRA disclosure if consumer reports will be used.
02

Collect Details: Obtain full name, DOB, address, and any identifiers required for matching.
03

Get Consent: Have the applicant sign and date the form; record how consent was given (paper, e-sign).
04

Submit Request: Send the signed release to your screening vendor or internal background check unit.

Configuring an Online Release Workflow

When digitizing the form, set fields and routing to capture consent, create an audit trail, and automate vendor delivery.

Field	Configuration
Name and DOB	Required text fields with exact-match validation where possible
SSN Handling	Secure field masked in transit and at rest; optional entry if vendor requires it
Consent Checkbox	Explicit consent with timestamp and IP capture
Delivery	Automated secure transfer to screening vendor via SFTP/API

Technical considerations for eSubmission and storage

Choose a platform that supports secure data handling, audit logs, and required authentication.

Data Encryption: TLS 1.2/1.3 in transit; AES-256 at rest
Audit Trail: Capture timestamps, IP addresses, and signer details
Integrations: Support for HRIS, ATS, and vendor APIs

Confirm platform compliance with applicable standards (for example HIPAA when handling protected health information) and retain a signed copy for your records.

Where to send the completed release

After signature, route the release to the appropriate party: internal HR, the selected screening company, or legal counsel depending on scope.

Internal HR: Store signed copy in the applicant file and trigger the screening request.
Screening Vendor: Transmit via secure API, SFTP, or vendor portal per contract.
Legal Counsel: Send if unusual scope, sensitive searches, or complex adverse-action risk exist.
Applicant: Provide a copy on request and supply required consumer-facing disclosures.

Typical Timelines and Processing Expectations

Turnaround times and retention expectations differ by vendor and search type; plan communications and decision timing accordingly.

Criminal Search Turnaround:

Often completes in 24–72 hours for basic searches; county-level checks may add days.

Employment/Reference Checks:

Can take 3–10 business days depending on third-party responsiveness.

Adverse Action Notices:

Provide pre-adverse notice and opportunity to dispute before final adverse action in line with FCRA timing.

RON Recording Retention:

If notarized remotely, audio-video recordings are commonly retained 5–10 years per state RON rules.

Applicant Record Requests:

Respond to reasonable applicant requests for copies within company policy and applicable law.

Common preparation mistakes to avoid

Using a one-line consent without specifying the scope, which can lead to overbroad searches or disputes.
Collecting social security numbers without clear justification or encryption, increasing privacy and compliance risk.
Failing to provide FCRA disclosures when using a consumer reporting agency, risking statutory penalties.
Not storing signed releases securely or failing to retain evidence of consent and the exact document version used.

Consequences of improper or incomplete releases

FCRA Violations: Potential statutory liability and corrective requirements

Invalid Consent: Searches may be inadmissible or subject to dispute

Privacy Breach: Regulatory fines and notification obligations

Adverse-Action Errors: Failure to provide notices can trigger penalties

Recordkeeping Failures: Inability to defend screening decisions

Operational Delays: Missed hiring or placement deadlines

Comparing eSignature platforms for managing History Check Release Forms

Platform choice affects cost, authentication options, and compliance support. signNow appears first for neutral comparison across common criteria and vendor price tiers.

	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	Varies
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	Varies	Varies
Envelope Cap	No cap	100 envelopes/user/year	Varies	Varies	Varies

Security and compliance features to require from vendors

Encryption: TLS/AES-256

Audit Trail: Signed event log

Access Controls: Role-based access

BAA Availability: Required for HIPAA

Authentication: Multi-factor options

Data Residency: Configurable retention

Frequently asked questions about History Check Release Forms

Answers below address common legal, technical, and procedural questions when collecting and using background-check authorizations.

Need help? Contact support

Can this form be signed electronically?
Yes. Electronic signatures are enforceable under the ESIGN Act (15 U.S.C. §7001) and UETA in adopted states, provided the four-element test of intent, consent, attribution, and record retention is satisfied.
When is an FCRA disclosure required?
An FCRA disclosure and separate written authorization are required whenever a consumer reporting agency provides a consumer report for employment or credit decisions (see FCRA, 15 U.S.C. §1681 et seq.).
How do I revoke or withdraw consent?
Revocation must be documented in writing; processing may depend on vendor policies and timing. Maintain clear records of any withdrawal and cease future checks absent lawful basis.
Is notarization ever required?
Not typically for standard releases, but state-specific documents or affidavits can require notarization or witnesses. Check local rules before adding notary fields.
What if the applicant disputes report accuracy?
Follow FCRA dispute procedures: allow the consumer to dispute directly with the reporting agency and pause adverse actions until the dispute is resolved if applicable.
How long should I keep signed releases?
Retain signed releases for the active purpose plus at least three years; follow industry rules such as HIPAA six-year retention for PHI and consider a seven-year post-termination retention policy for defense.

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