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NOTICE OF BACKGROUND CHECK [IMPORTANT -- PLEASE READ CAREFULLY
BEFORE SIGNING BELOW]
Note: Conducting a Social Security Trace does not access the
subject’s credit history nor affects the subject’s credit score or credit
rating. Please note that by signing below you are authorizing and instructing
an immediate criminal background and driving record reports from a third party
(utilizing a Social Security Number trace) as deemed necessary and appropriate.
Moreover, you are allowing reports from a third party on an ongoing basis
without any additional notice for as long as you are a member.
AUTHORIZATION AND INSTRUCTION I acknowledge receipt of the
NOTICE OF BACKGROUND CHECK and certify that I have read and understand that
notice. I hereby authorize and instruct ________________________________ to
obtain criminal background and/or driving record reports from a third party
(utilizing a Social Security Number trace) as deemed necessary and appropriate.
This authorization and instruction will take immediate effect when I sign below,
and will last throughout the duration of my involvement as a volunteer member.
Accordingly, you may obtain additional criminal background and/or driving record
reports from a third party on an ongoing basis throughout my association with
your organization without any further notice or additional warning. To this end,
I hereby authorize without reservation any law enforcement agency,
administrator, local, state or federal agency, information service bureau and/or
the Social Security Administration to furnish any and all background information
(including criminal history and/or driving records and not credit history)
requested by Backgroundchecks.com, another outside organization acting on your
behalf. I agree that a facsimile (“fax”) or photographic copy of this
Authorization and Instruction shall be as valid as the original.
Include a Legible Photo Copy of your Driver’s License Attached
to this document.
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Printed Name
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Social Security Number
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Signature
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Driver's License # &
State |
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Date |
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Date of Birth
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