Background Check Consent Form Template, Free Download 2026

DISCLOSURE PURSUANT TO THE FAIR CREDIT REPORTING ACT, 15 U.S.C. § 1681b(b)(2). NOTICE: As part of the application and/or employment process, [Company Name] ("Company") may obtain a "consumer report" and/or "investigative consumer report" (collectively, "consumer report") about you from one or more consumer reporting agencies ("CRAs"). A consumer report is a report prepared by a CRA that may contain information about your character, general reputation, personal characteristics, mode of living, credit history, and/or criminal history. This Disclosure is being provided to you pursuant to the Fair Credit Reporting Act ("FCRA"), 15 U.S.C. §§ 1681 et seq., and applicable state law.

An "investigative consumer report" is a consumer report in which information on your character, general reputation, personal characteristics, or mode of living is obtained through personal interviews with neighbors, friends, associates, or others who may have knowledge concerning such items of information. [Company] may obtain an investigative consumer report regarding your [background / references / education / employment history: ____________]. You have the right to request, within a reasonable time after this Disclosure, a complete and accurate disclosure of the nature and scope of the investigation requested. Please submit any such request to [____________] at [____________]. This Disclosure is a standalone document and no other information accompanies it.

AUTHORIZATION. I hereby authorize [Company Name] and its designated agents, representatives, and designated consumer reporting agencies (including [CRA Name, if known: ____________]) to obtain consumer report(s) about me for employment purposes (including, but not limited to, hiring, promotion, reassignment, and retention decisions). The consumer report(s) may include, but are not limited to, the following types of information: (a) Criminal history, including arrests, convictions, sex offender registration, and incarceration records at the federal, state, and county levels; (b) Credit history, including credit accounts, payment history, bankruptcies, judgments, and liens, to the extent permitted by applicable law; (c) Employment verification, including verification of dates of employment, positions held, compensation (if disclosed), and eligibility for rehire; (d) Education verification, including degrees, certifications, and dates of attendance.

The scope of the background investigation also includes: (e) Professional license verification, including status of any professional, trade, or occupational licenses or certifications; (f) Driving record / motor vehicle records ("MVR"), to the extent the position involves operation of a motor vehicle; (g) Social Security number trace and identity verification; (h) Reference interviews, including personal and professional references; and (i) [Other: ____________]. I understand that the Company will obtain this information from various federal, state, county, and local public records repositories, private databases, and through direct interviews, to the extent permitted by applicable law.

I authorize all persons, companies, educational institutions, financial institutions, law enforcement agencies, courts, and other entities to release information about me to [Company Name] and/or its designated consumer reporting agency. I release all such entities from any and all claims arising from providing this information. This Authorization is valid for this application and for any future updates or renewals of any background report obtained in connection with my employment or application for employment, for the duration of any employment relationship. A photocopy or electronic copy of this Authorization shall be as valid as the original.

YOUR RIGHTS UNDER THE FCRA. Before any adverse employment decision is made based in whole or in part on information contained in a consumer report, you will be provided with: (a) a copy of the consumer report; and (b) a written summary of your rights under the FCRA, entitled "A Summary of Your Rights Under the Fair Credit Reporting Act," prepared by the Consumer Financial Protection Bureau ("CFPB"). You will have a reasonable opportunity (not less than five (5) business days) to review the report and dispute any inaccurate information before any adverse action is taken.

You have the right to: (a) obtain a free copy of your consumer report from any CRA upon request, and an additional free copy within 60 days of receiving notice of adverse action; (b) dispute inaccurate information directly with the CRA, which must reinvestigate within 30 days; (c) know the name, address, and telephone number of the CRA that furnished the consumer report used in any adverse action; (d) seek damages from violators of the FCRA under 15 U.S.C. § 1681n (willful violations) or § 1681o (negligent violations), including actual damages, statutory damages, punitive damages, and attorneys' fees; and (e) have the CRA exclude you from lists for unsolicited credit and insurance offers. For more information about your rights, visit www.consumerfinance.gov or contact the CFPB at 1-855-411-2372.

STATE-SPECIFIC NOTICES. The following additional disclosures apply to residents of certain states: CALIFORNIA: Residents have additional rights under the California Investigative Consumer Reporting Agencies Act ("ICRAA") and California Consumer Credit Reporting Agencies Act. You have the right to receive a copy of the investigative consumer report at no charge, upon written request within a reasonable time after this Disclosure is provided. The Company will use [CRA Name, Address, Phone, Website] to obtain your consumer report. MINNESOTA / OKLAHOMA: You have the right to receive a copy of your consumer report upon request. NEW YORK: You have the right to inspect and receive a copy of any investigative consumer report obtained about you. WASHINGTON: You have the right to request the nature and scope of any investigation.

ADDITIONAL STATE-SPECIFIC NOTES: [California], Per California Labor Code § 1024.5, credit reports for employment purposes may only be obtained for positions specifically enumerated by statute. [Colorado, New York, Massachusetts, and other ban-the-box states], Criminal history inquiries are restricted prior to a conditional offer of employment; applicable state or local law governs. [Illinois], Per the Illinois Human Rights Act, certain criminal records may not be used in employment decisions. I acknowledge that I have read and understand this combined Disclosure and Authorization and that I have received a copy of "A Summary of Your Rights Under the Fair Credit Reporting Act." Applicant/Employee Signature: [____________]. Printed Name: [____________]. Date: [____________]. Social Security Number (for background check purposes only): [____________].