Applicant Employment Authorization Form

CAUTION: This is a Legal Form. You must be the Applicant to Sign This Form. The order will not be processed without your signed authorization as the applicant.

YOU MUST CLICK THE NEXT BUTTON AT THE BOTTOM OF THIS PAGE AND COMPLETE THE NEXT PAGE

Write you Full Legal Name (First, Middle, Last) EXACTLY as it appears on your Driver’s License or Passport.

Do Not Use a nickname, alias or abbreviation. If you have two last names, use them both.

"*" indicates required fields

Order ID*

Your Email*

Enter Email Confirm Email

Name*

First Middle Last

Other Last Names You Are Known By

Phone Number*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Applying To:*

Name of Employer

Email of Person to Receive your Report*

Email Address where we should send your screening report

Enter Email Confirm Email

Name

This field is for validation purposes and should be left unchanged.

YOU MUST CLICK THE NEXT BUTTON AND COMPLETE THE NEXT PAGE

Note: You can be charged with identity theft if you enter another person’s name or social security number, or any other information other than your own on an application. The Identity Theft Penalty Enhancement Act signed into legislation in 2004 established identity theft as a federal crime.