Free Employee Background Check Form Template
This FCRA-compliant background check authorization form collects the candidate's consent and personal information needed to run employment, education, and criminal record checks. Designed for US employers — especially service businesses, call centers, and BPOs that handle sensitive customer data.
Download Template (Google Docs) →
What the Form Covers
| Section | What it collects |
|---|---|
| Authorization & Consent | Written permission to check criminal history, employment, education, references, credit, MVR, drug screening |
| Personal Information | Full name, aliases, DOB, SSN, driver's license, current and previous addresses |
| Disclosure | FCRA-compliant notice of candidate rights regarding background reports |
| Acknowledgment | Candidate confirms understanding that employment may be contingent on results |
| Signature & Date | Candidate's signed consent |
| Company Use | Internal tracking — dates of authorization receipt, completion, and notes |
Full Form Text
Company Name:
Company Address:
Employee/Candidate Name:
Position Applied For:
Date:
1. Authorization and Consent
I, ________, hereby authorize ________ (the "Company") to conduct a background check for employment purposes. I understand that the background check may include, but is not limited to, the following:
- Criminal history
- Employment verification
- Education verification
- Reference check
- Credit history (if applicable)
- Motor vehicle record (if applicable)
- Drug screening (if applicable)
I give my full consent for this information to be collected and used by the Company to evaluate my eligibility for employment or continued employment.
2. Personal Information
Please complete the following information, which is required to conduct a background check:
Full Name: ______________________________
Previous Names/Aliases (if any): ______________________________
Date of Birth: ______________________________
Social Security Number (SSN): ______________________________
Driver's License Number (if applicable): ______________________________
Issuing State: ______________________________
Current Address:
Street: ______________________________
City: ______________________________
State: ______________________________
ZIP Code: ______________________________
Previous Address (if applicable):
Street: ______________________________
City: ______________________________
State: ______________________________
ZIP Code: ______________________________
3. Disclosure
In compliance with the Fair Credit Reporting Act (FCRA) and other relevant laws, I understand that:
3.1. The Company may request background reports, which may include criminal records, verification of previous employment and education, driving history, credit reports (where applicable), and other information necessary for employment purposes.
3.2. I have the right to request a copy of any background check report used in making an employment decision about me. If the Company considers any information in the background report when making an employment decision, I will be notified and provided with an opportunity to review and dispute the information.
4. Acknowledgment and Understanding
I understand that my employment, or continued employment, may be contingent upon the satisfactory results of the background check. I acknowledge that I have read and fully understand the contents of this form and voluntarily agree to provide the information necessary for conducting the background check.
I further release and hold harmless ________, its officers, employees, agents, and third-party background check service providers from any claims, damages, liabilities, and other costs that may arise as a result of the lawful collection, use, or disclosure of information obtained during the background check process.
5. Signature and Date
Signature of Employee/Candidate: ______________________________
Date: ______________________________
6. Company Use Only
Date Authorization Received: ______________________________
Background Check Completed By: ______________________________
Date Background Check Completed: ______________________________
Notes: ___________________________________________________
Legal Requirements to Know
This form is designed for FCRA compliance, but review it with your legal team before use. Key requirements:
FCRA
You must provide a standalone written disclosure that you may obtain a background report, and get the candidate's written consent before ordering it. The disclosure cannot include any other information besides the notice.
EEOC guidelines
Background check results cannot be used to discriminate based on race, gender, religion, or nationality. If you deny employment based on criminal history, you must conduct an individualized assessment.
State and local laws
Many states and cities have "ban the box" laws that restrict when you can ask about criminal history. Check your state labor laws for specific requirements.
Adverse action process
If you decide not to hire based on the background check, you must provide the candidate a copy of the report, a summary of their rights, and a reasonable period to dispute the findings before finalizing the decision.
Frequently Asked Questions
Common questions about employee background check forms.
Yes. The Google Docs template is fully editable. Add or remove sections based on your industry, state, or company policies.
Most third-party services provide their own authorization forms. However, having your own standardized form ensures consistency and gives you a company-branded document for your records. Some employers use both.
The EEOC recommends retaining hiring records (including background check forms) for at least one year after the hiring decision. Some states require longer retention periods.
You can make the background check a condition of employment. If a candidate refuses, you're within your rights to not proceed with the hiring process — but you should communicate this policy clearly upfront.
Yes, but you must obtain fresh written consent. Many employers include a clause in the initial authorization allowing periodic re-checks during employment. Check your state laws for specific requirements.
If you decide not to hire based on background check results, you must: (1) send a pre-adverse action notice with a copy of the report, (2) wait a reasonable period for the candidate to dispute, and (3) send a final adverse action notice if you proceed with the decision.
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