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AUTHORIZATION AND CONSENT FOR RELEASE OF INFORMATION
I hereby authorize HR Service Partners. and any of its agents/contractors/designated Company Personnel to disclose orally and in writing the results of this verification process and/or interview to the designated authorized representative of this Company.
AUTHORIZATION AND CONSENT FOR RELEASE OF INFORMATION
I have read and understand this release and consent, and I authorize the background verification. I authorize persons, schools, current and former employers, personal references, and other organizations and Agencies to provide HR Service Partners and any of its agents/contractors with all information that may be requested, and to conduct a verification, as deemed necessary by HR Service Partners to fulfill the job requirements, with regards to my motor vehicle records, credit history, Workers Compensation Insurance Claims as allowed by EEOC and FCRA, and to receive any criminal history record information pertaining to me which may be in the files of any Federal, State, or Local criminal justice agency in Texas or any other State. I hereby release all of the persons and Agencies providing such information from any and all claims and damages connected with their release of any requested information. I agree that any copy of this document is as valid as the original. All results will be proprietary and will be kept CONFIDENTIAL and disclosed orally and in writing only to the designated authorized representatives of this Company and its Clients.
I do hereby agree to forever release, discharge and indemnify HR Service Partners, and their associates to the full extent permitted by law from any claims, damages, losses, liabilities, costs and expenses, or any other charge or complaint filed with any agency arising from the retrieving and reporting of information.
Full Name - Last, First and Complete Middle Name
Maiden Name
Social Secutiry Number
Driver's License
Driver's License State
Date of Birth
Email
Current Home Address
Street Address Line 2
City
Region/State/Province
Postal / Zip code
Country
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How long have you resided at your current home address?
Previous Home Address
Street Address Line 2
City
Region/State/Province
Postal / Zip code
Country
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Your Signature - By signing this form electronically, you are agreeing to the terms and conditions stated herein.
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