Background Check Acknowledgment Form

BACKGROUND CHECK ACKNOWLEDGEMENT FORM I understand that I am entitled to a complete and accurate disclosure of the nature and scope of any investigative report of which I am the subject upon my written request to {Insert Name of Company}, if such is made within a reasonable time after the date hereof. I also understand that I may receive a written summary of my rights under 15 U.S.C. Section 1681 et. seq. I hereby release {Insert Name of Company} and any and all persons, business entities and governmental agencies, whether public or private, from any and all liability, claims and/or demands, by me, my heirs or others making such claim or demand on my behalf, for providing an investigative report hereby authorized. I understand that this Authorization/Release form shall remain in effect for the duration of my association with {Insert Name of Company}. I, the undersigned, do hereby authorize {Insert Name of Company} to procure an investigative report on me that includes social security verification and criminal history records.