Does the form require notarization?

Not typically. Pre-employment background authorization forms generally do not require notarization for FCRA purposes. Only use notarization if a specific state law or employer policy requires an acknowledged signature for a particular screening step.

Can the applicant sign electronically?

Yes. Electronic signatures meet ESIGN and UETA standards where the signer consents and intent is recorded. Capture authentication details and an audit trail to support attribution and retention requirements.

What if the applicant refuses to sign?

If an applicant declines authorization, you cannot lawfully obtain a consumer report. Document the refusal, consider alternative screening criteria permissible for the role, and treat the refusal consistently to avoid discrimination claims.

Is the Social Security number required?

A full SSN improves record matching but is not always required by law. If you collect an SSN, protect it as sensitive data and retain it only as needed. Consider collecting last four digits when full SSN is not permissible.

How long should I keep the signed form?

Retain signed authorizations as long as needed for the hiring decision and for statutory retention periods. Follow I-9 and industry-specific rules, and consult the applicable federal and state retention statutes before disposal.

What steps follow an adverse hiring decision?

Provide a pre-adverse action notice with a copy of the report and consumer rights summary, allow a reasonable period for dispute, then issue a final adverse action notice that states the employer’s basis and provides contact details for the screening agency.

Electronic Signature
Templates
HR
Pre-Employment Background Check Form

Pre-Employment Background Check Form

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

Pre-Employment Background Check Form

This form authorizes the prospective employer to obtain consumer reports, investigative consumer reports, criminal history, driving records, education verification, employment verification, and other background information necessary to evaluate suitability for employment. All information provided below will be used solely for background screening and hiring decisions and will be handled in confidence consistent with applicable law.

Personal Information

Full Legal Name Other Names Used (aliases, maiden name) Current Address

Phone:

Email:

Date of Birth:

Social Security Number:

Position Information

Position Applied For Department / Hiring Manager

Requested Start Date:

Proposed Salary / Rate:

Employment Type (select all that apply)

Full-time Part-time Temporary/Contract

Employment History

Provide complete employment history for the past 10 years. Begin with most recent employer.

Employer 1 — Company Name

Job Title:

Start Date:

End Date:

Primary Responsibilities

Employer 2 — Company Name

Job Title:

Start Date:

End Date:

Primary Responsibilities

Education

Highest Degree / Certification Institution

Graduation Date:

Additional Education / Training

References

Provide three professional references who can attest to your work history and character.

Legal Disclosures & Authorization

At-Will Employment: I understand and agree that, if hired, my employment will be at-will, meaning either I or the employer may terminate the employment relationship at any time with or without cause or notice, unless otherwise provided in a written agreement signed by an authorized company representative.

Equal Opportunity: The employer is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, or other protected characteristics in accordance with applicable law.

Disclosure and Authorization: I hereby authorize the employer and its designated agents and representatives to obtain consumer reports and investigative consumer reports for employment purposes. These reports may include, but are not limited to: employment verification, education verification, criminal history, motor vehicle records, credit history where job-related, and professional license verification. I authorize any person, school, current employer, former employer, organization, or governmental agency to release to the employer any information requested in connection with such reports.

I understand that a consumer reporting agency may prepare a report about me and that I have rights under federal and state law to obtain a copy of any report and to dispute inaccurate information. I further understand that, should information in a report be used as a basis for an adverse decision, I will be provided notice and an opportunity to respond as required by law.

Authorization (select each to grant authorization)

Employment verification Education verification Criminal history check

Driving record / motor vehicle report Credit report (if applicable) Professional license verification

These authorizations are valid for the duration of my application and, if hired, for the course of my employment where permitted by law. I release from liability any person or entity providing information in good faith pursuant to this authorization.

Applicant Certification

I certify that all information provided on this form and any attachments is true, correct, and complete to the best of my knowledge. I understand that falsification, omission, or misrepresentation of facts on this form or during the hiring process may result in denial of employment or, if employed, termination of employment.

I further authorize the employer to obtain background reports as described above and to use the information obtained as part of its hiring decision. I understand that I may be required to provide additional documentation or to sign additional release forms if required by the reporting agency or by law.

Applicant Statement: Please initial to acknowledge

I certify that the facts set forth in this form are true and complete. I authorize the release of the information described above.

Additional Information

Additional Comments (employment gaps, explanations, or other relevant information)

Applicant Name:

Signature:

Date:

What the Pre-Employment Background Check Form Is and When to Use It

The Pre-Employment Background Check Form is a written authorization that allows an employer or third-party screening provider to obtain consumer and public-record information about a job applicant. Typical checks cover criminal history, employment and education verification, motor vehicle records, and consumer credit where job-related and permitted. Use this form before ordering a consumer report so the employer documents informed consent, complies with FCRA disclosure and authorization requirements, and preserves a defensible audit trail if adverse action proceeds.

Why a Proper Authorization Matters

A properly completed Pre-Employment Background Check Form documents applicant consent, supports FCRA compliance, and reduces legal risk when employers assess suitability. Clear authorization language and accurate applicant data speed vendor processing and preserve evidence for any subsequent adverse action.

Who Prepares and Signs This Form

Employers, HR teams, hiring managers, and authorized background-check vendors are the primary preparers and recipients of this authorization form.

Small and mid-size employers — centralize consent tracking for each hire and link reports to personnel files.
Enterprise HR teams — integrate authorization into applicant tracking and vendor workflows for volume screening.
Background-screening agencies — require a clear, signed authorization before releasing consumer reports to employers.

The applicant signs; HR retains a copy and the screening vendor documents receipt and completion in the hiring record.

Step-by-Step: Completing the Pre-Employment Background Check Form

Follow these essential steps to collect valid authorization and order a consumer report without delay.

01

Prepare the form: Include employer name, purpose, and required disclosure language.
02

Collect applicant data: Get full name, DOB, SSN (or last 4), and current address.
03

Obtain signature: Have applicant sign and date; capture signature method.
04

Send to vendor: Transmit form and identity details securely to the screening provider.

How to Configure an Online Authorization Workflow

Set these workflow fields when sending the form electronically to ensure authentication, routing, and secure storage.

Field	Configuration
Authentication	Email link plus optional SMS code
Required Fields	Full name, DOB, SSN (or last 4), address, signature
Routing	Signers in order: applicant → HR reviewer → background vendor
Retention Policy	Store signed copy for minimum statutory period

Where the Completed Form Should Go

Route the signed authorization to the parties that need it and record the transfer for audit purposes.

Employer HR: Retain in the candidate file for compliance.
Background Vendor: Transmit securely for report generation.
Hiring Manager: Provide a summary or redacted copy as needed.
Records Archive: Store signed form in a secure repository.

Digital Signing and eSubmission Essentials

Use an eSignature platform that supports secure upload, field placement, signer authentication, and an unalterable audit trail.

File formats: PDF, DOCX supported
Integrations: HRIS/ATS and cloud storage
Authentication: Email, SMS, or KBA options

Verify the provider offers audit logs, encryption in transit and at rest, and a retention mechanism that meets federal and state recordkeeping requirements.

eSignature Pricing Snapshot for Background Authorization Forms

Compare common pricing and capability dimensions to choose an eSignature provider that supports HIPAA/enterprise workflows and bulk processing needs.

	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 by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes (Premium tier)	Varies by plan	Varies by plan	Varies by plan	Varies by plan
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

Essential Data Elements to Collect

Applicant name: Full legal name

Date of birth: MM/DD/YYYY

Social Security: Full SSN or last four

Current address: Street, city, state, ZIP

Employment history: Employer names and dates

Signature: Signed authorization and date

Common Mistakes That Delay Background Checks

Failing to include a clear, standalone disclosure and authorization that meets FCRA requirements.
Entering incomplete or misspelled names, addresses, or DOBs that produce false matches or no records.
Requesting unauthorized records such as credit checks without job-related justification or proper disclosure.
Skipping the required adverse-action steps after a decision based on a consumer report.

Consequences of Noncompliance

FCRA liability: Civil suits and statutory damages

I-9 penalties: $281–$2,789 per violation

Adverse action risk: Procedural errors can invalidate adverse action

State fines: State consumer-protection penalties possible

Privacy breach: Exposure of SSNs risks identity-theft liability

Reputational harm: Regulatory citations and public complaints

Practical Tips for Accurate and Efficient Completion

Adopt these practices to reduce processing time, limit legal exposure, and keep candidate experience smooth.

Use precise disclosure language

Include a clear, standalone consumer disclosure that explains the employer will obtain a consumer report and obtain affirmative, unambiguous consent in writing or electronically. This prevents FCRA disclosure disputes and supports a defensible record of authorization.

Match identity fields carefully

Collect and verify full legal name, DOB, and SSN (or last four) and prior addresses when possible. Accurate identity matching reduces duplicate searches and minimizes manual vendor follow-up, which delays hiring timelines.

Record the signature method and time

For electronic signatures, capture the signer’s email, IP address, authentication method, and timestamp. For wet signatures, scan and log the signed document with a retention date to ensure consistent auditability.

Follow adverse-action steps

If a decision is based on a consumer report, provide a pre-adverse action notice with a copy of the report and a summary of rights, allow time for dispute, then issue a final adverse action notice that documents the basis and required consumer disclosures.

Real-World Examples of Authorization Workflows

These customer scenarios show how organizations integrate background authorization into hiring and vendor workflows.

Optica Ventures — COO

Optica centralized electronic authorizations to speed candidate processing and reduce paperwork.

The team used a single standardized form for all hires.
Centralization allowed consistent vendor submissions and improved traceability for audit reviews while reducing back-and-forth with applicants.

Fertility Centers of Illinois — Founder

The organization required secure, mobile-friendly consent collection for hires across clinics.

They needed HIPAA-aware handling for limited health-related checks.
Using a standardized e-auth form retained audit trails and ensured signed authorizations were stored securely with controlled access for compliance.

Frequently Asked Questions About the Authorization Form

Answers to common questions about completion, e-signing, required fields, and compliance for Pre-Employment Background Check Forms.

Need help? Contact support

Does the form require notarization?
Not typically. Pre-employment background authorization forms generally do not require notarization for FCRA purposes. Only use notarization if a specific state law or employer policy requires an acknowledged signature for a particular screening step.
Can the applicant sign electronically?
Yes. Electronic signatures meet ESIGN and UETA standards where the signer consents and intent is recorded. Capture authentication details and an audit trail to support attribution and retention requirements.
What if the applicant refuses to sign?
If an applicant declines authorization, you cannot lawfully obtain a consumer report. Document the refusal, consider alternative screening criteria permissible for the role, and treat the refusal consistently to avoid discrimination claims.
Is the Social Security number required?
A full SSN improves record matching but is not always required by law. If you collect an SSN, protect it as sensitive data and retain it only as needed. Consider collecting last four digits when full SSN is not permissible.
How long should I keep the signed form?
Retain signed authorizations as long as needed for the hiring decision and for statutory retention periods. Follow I-9 and industry-specific rules, and consult the applicable federal and state retention statutes before disposal.
What steps follow an adverse hiring decision?
Provide a pre-adverse action notice with a copy of the report and consumer rights summary, allow a reasonable period for dispute, then issue a final adverse action notice that states the employer’s basis and provides contact details for the screening agency.

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