HR Permission Letter

HR PERMISSION LETTER

Personal Information

Employee Name:   Employee ID:

Phone:   Email:

Position Information

Reporting Manager:   Proposed Start Date:

Permission Granted

By signing this HR Permission Letter, I authorize the company and its agents to perform or obtain the following in support of my employment, placement, or continued employment. I expressly authorize each type of inquiry I select below to the extent permitted by applicable law.

Background check (criminal history, national/state/local records)

Employment verification with prior employers

Reference checks (professional references)

Education verification

Drug/alcohol testing as required by company policy

Release of medical or leave-related records from health providers (limited to job-related information)

Authorization to Contact Previous Employers and Obtain Records

I authorize any prior employer, educational institution, reference, medical provider, licensing authority, government agency, or other party to release to the company and its designated agents any information they have regarding my employment, education, licensing, medical leave, or other records pertinent to my employment. This authorization includes the release of dates of employment, job title(s), performance records, disciplinary records, reason for separation, eligibility for rehire, and any other information reasonably related to the company’s legitimate business needs.

Consent Effective Date:   Consent Expiration Date (if any):

At-Will Employment & Equal Opportunity Statement

Nothing in this Permission Letter is intended to alter the at-will nature of employment unless expressly stated in a separate written agreement signed by an authorized company representative. The company retains the right to terminate employment at any time, with or without cause or notice, subject to applicable law.

The company is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, genetic information, or other status protected by law. Reasonable accommodations will be considered following applicable law.

Employment History (Most Recent - 1)

From:   To:

Employment History (Previous - 2)

From:   To:

Education

Graduation Date:

Professional References (3)

Applicant Certification and Authorization

I certify that all information provided in this document is true and complete to the best of my knowledge. I understand that falsification, omission, or misrepresentation of information may result in withdrawal of an offer, discipline, or termination of employment. I authorize the company and its designated agents to obtain, use, and disclose the information described above for employment-related purposes.

I certify and acknowledge the statements above and authorize the disclosures as indicated.

I hereby release and agree to hold harmless any party furnishing information to the company and the company, its agents, employees, successors and assigns, from any liability arising out of the procurement, use, or disclosure of such information, to the extent permitted by applicable law.

I understand that I may revoke this authorization at any time by delivering a written notice to the company, but that such revocation will not affect any actions taken in reliance on this authorization prior to receipt of revocation.

Notice Regarding Background Checks and Rights

If a background check or consumer report is obtained that results in an adverse action (including a decision not to hire or to terminate employment), the company will provide the required pre-adverse and adverse action notices as required by law. You have the right to dispute the accuracy of any consumer report or background information in accordance with applicable regulations.

Optional Additional Authorizations

If you wish to withhold authorization for any specific inquiry, describe that limitation here. The company may evaluate whether limiting authorization affects employment eligibility.

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