Can this form be signed electronically?

Yes. Electronic signatures meet ESIGN and UETA requirements if intent, consent, attribution, and reliable record retention are demonstrated. Consumer-facing disclosures required by ESIGN (15 U.S.C. §7001) must be provided when applicable.

What if the candidate refuses to provide an SSN?

If a full SSN is not provided, use alternate identity fields per vendor guidance; note that missing SSNs can limit search accuracy and may require additional identity verification steps.

Do I need a separate disclosure for adverse-action steps?

Yes. Before taking adverse action based on a consumer report, provide the required pre-adverse notice and a copy of the report; follow the FCRA-mandated timing and procedures.

How should signed forms be stored securely?

Store signed forms in encrypted archives with access controls, maintain audit trails, and limit access to authorized HR personnel. Retain per legal retention schedules for I-9 and other regulated documents.

Are witness or notarization steps required?

Not typically for background consent forms. If a jurisdiction or specific policy requires notarization or RON, follow the state’s notary rules and ensure the notary’s record is retained.

What happens if a form contains errors?

If data errors affect identity matching, obtain a corrected form and document the correction. Keep original and corrected copies to show the timeline of consent and correction.

Electronic Signature
Templates
HR
HR Background Check Information Form

HR Background Check Information Form

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

HR BACKGROUND CHECK INFORMATION FORM

This Background Check Information Form collects data required to perform pre-employment background screening and verifications. Applicant provides the information below and authorizes the Company and its authorized background screening agents to obtain consumer reports, criminal history, driving records, education and employment verifications, and other lawful background information as described in the authorization. Providing false or incomplete information may be grounds for denial of employment or termination.

Company and Position

Company Name:

Position Applied For: Department:

Reporting Manager: Anticipated Start Date:

Offered Salary/Rate:

Personal Information

Full Legal Name Other Names/Aliases Used (including maiden names)

Date of Birth

Social Security Number

Current Address Previous Address (if at current address less than 7 years)

Primary Phone

Secondary Phone

Email Address

Driver's License Number

Issuing State

Employment History (Most Recent First)

Employer 1 - Company Name

Job Title

Start Date

End Date

Primary Responsibilities Reason for Leaving

Employer 2 - Company Name

Job Title

Start Date

End Date

Primary Responsibilities Reason for Leaving

Education

Highest Degree Earned Institution

Graduation Date

Major/Field of Study

Professional References

Reference 1 Reference 2 Reference 3

Legal Disclosures and Consents

At-Will Employment Statement: I understand that unless otherwise provided in a written agreement signed by an authorized representative of the Company, my employment is at-will and may be terminated by either party at any time, with or without cause or notice.

Equal Opportunity Statement: The Company prohibits discrimination and harassment based on protected characteristics and considers qualified applicants without regard to race, color, religion, sex, national origin, age, disability, or any other protected status under applicable law.

Criminal History Disclosure: Have you ever been convicted of a felony or misdemeanor? Yes No

If yes, provide details (offense, date, jurisdiction, disposition)

Background Check Authorization (please read and initial): I voluntarily and knowingly authorize the Company and its authorized agents to obtain consumer reports and investigative consumer reports necessary to make employment decisions. This authorization includes, where applicable, criminal background checks, credit reports for positions of financial responsibility, motor vehicle records, education verification, employment verification, and references. I understand that such reports may include information about my character, general reputation, personal characteristics, and mode of living.

Types of checks authorized (check all that apply):

Criminal Records Check Motor Vehicle/Driving Record Check Employment Verification Education Verification

Credit Check (required only for positions with financial responsibilities) Professional References

Additional Consents or Limitations

Applicant Certification and Authorization

I certify that all information provided on this form is true, complete, and correct to the best of my knowledge. I understand that falsification, omission, or misrepresentation of facts may result in refusal to hire or, if employed, immediate termination. I authorize all persons, schools, current and former employers, law enforcement agencies, and other organizations to provide the Company and its agents with any and all information requested in connection with my background investigation.

I hereby release from liability the Company and its agents and any person or entity supplying information in good faith and without malice. I also understand that, if required by applicable law, I will receive a pre-adverse action notice and a copy of any consumer report and a description of my rights prior to any adverse employment decision based on such report.

I acknowledge receipt of this authorization and certify my consent by signing below.

Applicant Printed Name:

Signature:

Date:

What the HR Background Check Information Form Is

The HR Background Check Information Form collects the data an employer needs to request consumer background reports, verify identity, and document authorization to review criminal, employment, education, and credit history where permitted. It typically records the applicant’s full legal name, date of birth, current and previous addresses, Social Security number (or partial SSN where allowed), signature and date, and any disclosures required by the Fair Credit Reporting Act (FCRA). The completed form creates a clear record of consent and the specific reporting purposes to support compliance with hiring and adverse-action procedures.

Why this Form Matters for HR and Compliance

A properly completed HR Background Check Information Form documents candidate consent, supports lawful use of consumer reports, reduces litigation risk, and creates an auditable record for hiring decisions.

Who Completes and Relies on This Form

Keep completed forms with the candidate file and follow retention rules for I-9s, adverse-action records, and industry-specific regulations.

HR teams and hiring managers who must document consent and the permissible purpose for background checks.
Third-party background screening providers who require verified applicant data to run accurate searches.
Legal, compliance, and talent acquisition teams that need a retained record to support adverse-action steps.

Step-by-Step: How to Complete the Form

Follow these steps to collect authorization and prepare for ordering a background report.

01

Prepare Form: Provide the correct version with FCRA disclosure included.
02

Collect Data: Have the candidate enter name, DOB, address, and SSN as instructed.
03

Obtain Consent: Ensure the disclosure is clear and the candidate signs or e-signs.
04

Order Report: Submit data to your screening vendor and retain the signed form.

Essential Components to Include on a Professional Form

A compliant HR Background Check Information Form combines identity data, clear disclosures, a consent signature, and retention instructions so records can support hiring decisions and any required adverse-action steps.

Applicant Identity

Fields for full legal name, aliases, date of birth, and government-issued ID details to reduce false matches and support accurate searches.

Contact and Address History

Current and previous addresses (commonly last seven years) and phone/email contact to help match records from multiple jurisdictions.

SSN or Identifier

Space for Social Security number or permitted identifier; include guidance where local law prohibits full SSN collection.

FCRA Disclosure

Clear, standalone disclosure describing that consumer reports may be obtained and listing the employer as the requester, as required by FCRA.

Authorization and Signature

A dated signature block with explicit consent language authorizing consumer reports and any rechecks as required for employment.

Adverse-Action & Retention Notes

Fields or checkboxes noting whether a pre-adverse or adverse-action notice was provided and where the signed form will be retained.

Required Data Elements for Screening Requests

Full Name: Exact legal name

Date of Birth: MM/DD/YYYY

Current Address: Street, city, state, ZIP

Social Security Number: Full SSN or permitted alternative

Consent Statement: Signed authorization

Signature Date: MM/DD/YYYY date

Customizing the Online Form Workflow

Configure the digital workflow to capture consent, enforce required fields, and route signed forms to HR and vendor systems.

Field	Configuration
Required Flags	Make name, DOB, address, and consent required
Conditional Fields	Show prior address fields if candidate selects multi-year history
Signature Capture	Allow handwritten e-sign or typed name with audit trail
Routing	Send signed copy to HR, background vendor, and archived storage

Digital Signing and Distribution Requirements

Confirm the solution meets your privacy and compliance needs, supports conditional fields, and keeps signed copies searchable in your records system.

PDF/DOCX Support: Accepts standard file formats
Audit Trail: Captures IP, timestamp, and signer details
Integration: Connects with HRIS and background vendors

Where to Send and How the Submission Works

Typical routing sends the signed form to HR, the background screening vendor, and a secure archive; automated workflows reduce manual handling and help enforce retention policies.

HR Archive: Store signed form in encrypted personnel file
Screening Vendor: Transmit data securely via API or secure upload
Applicant Copy: Provide a signed copy to the candidate
Audit Log: Retain metadata for compliance reviews

Timelines and Processing Expectations

Understand typical response windows and time-sensitive steps so hiring decisions and adverse-action notices meet legal expectations.

Report Turnaround:

24–72 hours for standard checks

Adverse-Action Notice:

Provide pre-adverse notice before final action

Corrective Response:

Allow 30 days for candidate dispute resolution

Rechecks:

Schedule periodic rechecks per policy

Retention Start:

Retention begins on signature date

Common Errors and Pitfalls to Avoid

Collecting incomplete identifiers (missing SSN or DOB) that produce false negatives or delay searches.
Failing to include the required FCRA disclosure and standalone authorization before ordering a consumer report.
Using an outdated form that lacks local- or state-specific notices, which can invalidate consent in certain jurisdictions.
Not preserving the audit trail and signed copy, leaving the employer unable to demonstrate consent during an adverse-action challenge.

Legal and Operational Risks of Incorrect Forms

FCRA Liability: Civil penalties and statutory damages

I-9 Violations: Fines per 8 CFR if records missing

State Penalties: Local fines for noncompliance

Litigation Costs: Defense and settlement expenses

Hiring Delays: Operational disruption

Reputational Harm: Candidate trust erosion

eSignature Pricing Comparison for HR Background Check Workflows

Compare common pricing and capability points for eSignature providers used to collect consent and signatures for background screening forms.

	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 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

Frequently Asked Questions and Troubleshooting

Answers to common questions about completing, signing, and storing HR Background Check Information Forms.

Need help? Contact support

Can this form be signed electronically?
Yes. Electronic signatures meet ESIGN and UETA requirements if intent, consent, attribution, and reliable record retention are demonstrated. Consumer-facing disclosures required by ESIGN (15 U.S.C. §7001) must be provided when applicable.
What if the candidate refuses to provide an SSN?
If a full SSN is not provided, use alternate identity fields per vendor guidance; note that missing SSNs can limit search accuracy and may require additional identity verification steps.
Do I need a separate disclosure for adverse-action steps?
Yes. Before taking adverse action based on a consumer report, provide the required pre-adverse notice and a copy of the report; follow the FCRA-mandated timing and procedures.
How should signed forms be stored securely?
Store signed forms in encrypted archives with access controls, maintain audit trails, and limit access to authorized HR personnel. Retain per legal retention schedules for I-9 and other regulated documents.
Are witness or notarization steps required?
Not typically for background consent forms. If a jurisdiction or specific policy requires notarization or RON, follow the state’s notary rules and ensure the notary’s record is retained.
What happens if a form contains errors?
If data errors affect identity matching, obtain a corrected form and document the correction. Keep original and corrected copies to show the timeline of consent and correction.

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now