ABC Shoes Background Check Authorization Form
Applicant Information
Full Name: ___________________________________________
Date of Birth: ________________________________________
Social Security Number: _______________________________
Current Address:
_______________________________________________
_______________________________________________
(Street, City, State, Zip)
Phone Number: ________________________________________
Email Address: _______________________________________
Authorization for Background Check
ABC Shoes requires a background check as part of its hiring process to ensure the safety, trust, and quality standards of our team. By completing this form, you authorize ABC Shoes to conduct a background check, which may include verification of personal information, employment history, education, and criminal records.
Please check each box below to indicate your consent:
· _______ Identity Verification: Verification of your name, address, and identification details.
· _______ Employment Verification: Review of past employment, including roles, dates, and reasons for leaving.
· _______ Education Verification: Confirmation of educational history, including degrees, certifications, and institutions attended.
· _______ Criminal Record Check: Screening for any past criminal convictions in compliance with applicable laws.
· _______ Credit Check (if applicable): Review of credit history for roles with financial responsibilities.
Acknowledgment and Signature
I, __________________________________ (applicant name), authorize ABC Shoes or its designated agent to conduct a background check as part of the hiring process. I understand that the results of this check will be used solely to assess my suitability for the position applied for and that my information will be kept confidential.
I also understand that if any information provided is found to be false or misleading, it may disqualify me from employment consideration or result in immediate termination.
Applicant Signature: __________________________________
Date: __________________________________
For ABC Shoes Use Only
Requested by (Hiring Manager): __________________________________
Position Applied For: __________________________________
Date Request Sent: __________________________________