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Background Verification Declaration Form Template

Simplify Your Hiring Process with This Essential Template

Navigating the complexities of hiring can be daunting, especially when it comes to obtaining essential background checks. This Background Verification Declaration Form Template assists HR professionals and hiring managers like you in collecting necessary consent efficiently and transparently. It streamlines the verification process, builds trust with applicants, ensures compliance with legal standards, simplifies record-keeping, and enhances the overall hiring experience. Explore this ready-to-use template to ensure a smoother hiring journey.

Use this Template (FREE) Live Preview
Full legal name
Other names used (aliases, maiden names) if any
Date of birth
Last 4 digits of National ID/SSN (if applicable)
Country of citizenship
Email address
Mobile phone number
Current residential address (include street, city, state/province, postal code, country)
Previous residential address in the last 5 years (if applicable)
How long have you lived at your current address?
Less than 6 months
6 to 12 months
1 to 3 years
3 to 5 years
More than 5 years
Prefer not to say
Position or role applied for
Employer or organization requesting this check
Country/state where this background check will be conducted
May we contact your current employer?
Yes
No
Which background checks do you authorize? (select all that apply)
I have received and read a standalone disclosure explaining the background check.
Yes
No
I authorize the procurement of background reports for employment or engagement purposes.
Yes
No
Authorization scope
One-time report for pre-employment/engagement
Periodic or ongoing reports during employment/engagement
Both one-time and ongoing reports
Not applicable
I certify that the information I have provided in this form is true, accurate, and complete.
True
False
Optional: Additional information or context relevant to the background check
Parent or guardian full name (if under 18)
Are you under 18 years of age?
Yes
No
Type your full name as your electronic signature
Date of signature
I acknowledge that my typed name constitutes my electronic signature.
Yes
No
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Paper art illustration related to background verification declaration form template and FormCreatorAI concept

When to use this form

Use this declaration when you need clear consent to run background checks for hiring, contracting, internships, or volunteer placements. It helps you confirm identity, work history, education, and references before making an offer. Pair it with the Application verification form to match claims against submitted details. To confirm pay and employment dates, add a Wage verification form. It also fits vendor onboarding and role changes where security or compliance matters, such as finance, healthcare, and childcare. Candidates benefit too: they know what you will check, why, and how you will contact sources. The result is faster decisions, fewer surprises, and a documented audit trail.

Must Ask Background Verification Declaration Questions

  1. Do you authorize us to verify your identity, education, employment, and references with third parties?

    Your consent lets us contact schools, employers, and referees and collect records lawfully. It speeds up checks and reduces back-and-forth.

  2. Do you confirm the information you provided is true, complete, and up to date?

    Accurate data improves screening results and fairness. A clear attestation sets expectations and supports decisions if inconsistencies appear.

  3. May we verify your employment history, including job titles, dates, supervisors, and reasons for leaving?

    This focuses the scope so sources know exactly what to share. If you ran your own business, we may use client references or documents, supported by a Self-employment verification form.

  4. Where permitted by law, have you had any criminal convictions relevant to this role? If yes, please provide dates and details.

    Disclosing relevant history helps assess risk and allows you to explain context, rehabilitation, and outcomes. For faith-based or volunteer roles, we follow processes similar to our Church background check form.

  5. Do you authorize us to use a screening provider and contact your current or former employers to confirm employment status and, where allowed, compensation?

    This clarifies who may contact whom and helps prevent delays or disputes later. It also creates a clear audit trail tied to your signature and date.

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