Background check authorization form
Before you order a background check on an applicant or employee through a screening company, federal law asks for two things: a clear written disclosure, on its own, that you'll get a report, and their written permission. This template puts the standalone disclosure first and the authorization after it, with nothing extra mixed in. Read it below, add your screening company's details and send it to sign.
Updated November 5, 2026 · 4 min read
The contract
Gray blanks are yours to fill in before you send. Each signer fills in the blanks in their color.
- You, before sending
- Applicant
Background Check Disclosure and Authorization
1. Disclosure regarding background reports
Company name (the "Company") may obtain information about you from a consumer reporting agency for employment purposes. This means the Company may get a consumer report, also called a background check, about you to help decide whether to hire you. If you are hired, and as allowed by law, the Company may obtain further consumer reports about you at any time during your employment for purposes such as promotion, reassignment or retention.
A consumer report may contain information about your criminal history, driving record, employment history, education, professional licenses and credentials, identity and address history, and, where the law allows and the job requires it, your credit history. The information may come from public records, past employers, schools and other sources.
2. Investigative consumer reports
The report may be an investigative consumer report, which includes information about your character, general reputation, personal characteristics or mode of living, gathered through personal interviews with people such as past employers, coworkers and references. You have the right to make a written request, within a reasonable time, for a complete and accurate disclosure of the nature and scope of any investigative consumer report the Company requests.
3. The consumer reporting agency
The reports will be prepared by Screening company name, Screening company address, telephone Screening company phone, website Screening company website. You may contact the agency directly to ask what is in your file and to dispute anything that is inaccurate or incomplete.
4. Authorization
I have read the disclosure above. I authorize the Company to obtain consumer reports and investigative consumer reports about me from the consumer reporting agency named in section 3, for employment purposes, now and, if I am hired, at any time during my employment as allowed by law. I authorize anyone the agency contacts, including past employers, schools, courts and motor vehicle departments, to provide the information it requests. A copy of this authorization is as valid as the original.
5. Applicant information
Full legal name: Full legal name. Other names used, including maiden names: Other names used.
Current address: Current address. Email: Applicant email. Phone: Applicant phone.
Driver's license number and state, if a driving record will be checked: Driver's license. The consumer reporting agency will collect any other identifying details it needs, such as date of birth, directly from you.
6. Copy of the report
Please send me a free copy of any consumer report the Company obtains about me.
Applicant
Opens it in SignMaster as a template you can edit and send.
A starting point, not legal advice. Have a lawyer review it for your state and situation.
On this page
The rule that trips employers up
The Fair Credit Reporting Act says the disclosure must be clear and conspicuous, in a document that consists solely of the disclosure. Courts take that literally. Employers have faced class actions for adding a liability waiver, state notices or an at-will paragraph to the same document. The applicant's authorization may sit on the disclosure; everything else goes in its own document.
The rule applies whenever a consumer reporting agency, meaning a screening company, supplies the report: criminal records, driving records, past employment, education or credit. If you call references yourself, the FCRA doesn't apply, though your state's law might.
What the template covers
- Disclosure: a plain statement that you may get a consumer report for employment purposes, before hiring and, if you choose, during employment.
- Investigative reports: notice that the report may include interviews with references, and the right to ask about its nature and scope.
- The screening company: its name, address, phone and website, filled in by you.
- Authorization: the applicant's written permission, signed and dated.
- Applicant details: name, other names used, and a driver's license number if you check driving records.
- A copy of the report: a tick box to request a free copy, which some states require you to offer.
The rest of the process
- Before the report: give the disclosure, get the signature, and give any state notices as separate documents.
- Before acting on it: if the report may lead you to say no, send a pre-adverse action notice with a copy of the report and the CFPB's Summary of Your Rights, then wait a reasonable time for the applicant to respond.
- After deciding: send the adverse action notice, naming the screening company and explaining the right to dispute the report.
Mistakes to avoid
- Adding a release of liability. It's the most common reason a disclosure fails the standalone rule.
- Putting state notices on the same page. California, New York, Washington and others have their own; send them as separate documents in the same envelope.
- Asking too early. Many states and cities have fair-chance laws that delay criminal history checks until after a conditional offer.
- Collecting Social Security numbers and birth dates here. Let the screening company gather those through its own secure portal.
- Skipping the pre-adverse action step. An applicant who never saw the report never had a chance to point out a mistake in it.
How to send it with SignMaster
- 1
Open the template
Choose Use this template above. The applicant is the only signer, and a hiring manager is set up as a CC who gets the signed copy.
- 2
Add your screening company
Fill in the gray blanks with your company name and the screening company's name, address, phone and website, exactly as they appear on its paperwork.
- 3
Keep state notices separate
Upload any state disclosure your screening company provides as its own document in the same envelope. It travels with the form without sitting inside it.
- 4
Send it to the applicant
They read the disclosure, fill in their details, tick the box if they want a copy, and sign on any phone or computer.
- 5
Order the report
The signed PDF and its certificate show exactly when the applicant authorized the check. Pass the PDF to your screening company, or upload it to its portal.
Hiring a seasonal crew? Bulk send sends each applicant their own form from a CSV of names and emails, and the template's Responses tab shows every applicant's answers in one table, so you can see who has authorized a check before you order it.
Questions? Answers.
Can a background check authorization be signed electronically?
Generally, yes. The FCRA asks for the disclosure and authorization in writing, and the ESIGN Act lets an electronic record and signature meet a writing requirement. Keep the disclosure on its own and give the applicant a copy.
Does the disclosure really have to stand alone?
It has to be in a document that consists solely of the disclosure, and the authorization may be on it. Courts read that strictly, so keep waivers, state notices and anything else in separate documents.
Do I need a new authorization for checks during employment?
Not under federal law if the original authorization clearly covers checks throughout employment, as this one does. Some states expect a fresh notice before each report, so check with your screening company.
What's an investigative consumer report?
A report built partly from interviews, such as conversations with former employers or references about character and reputation. The FCRA requires a specific notice for those, which this template includes.