Fillable Consent For A Background Investigation - University Of Georgia printable pdf download

Consent For A Background Investigation - University Of Georgia

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Human Resources

Consent for a Background Investigation

View the Background Investigation policy:

To be completed by the UGA department

UGA department

UGA title of position being checked

UGA departmental contact name

Contact daytime phone

Contact email address

REQUIRED for all new hires and new volunteers:

MVR - Driver’s License

State __________________ DL# _________________________

This is a reclassification.

For individuals who are or will be issued a P-card, check ONE:

This is a new employee who will be issued a P-card (Background and credit checks)

This is a current employee who will be issued a P-card (Background and credit checks)

This is a current employee whose P-card is being renewed (Background and credit checks)

To be completed by the applicant/employee

In connection with your application for employment (including contract for services) with The University of Georgia, you understand that consumer

reports or investigative consumer reports may be requested about you including information about education verification, criminal record, and sexual

offender status, and may involve public record or various federal, state, or local agencies. If your duties involve significant fiscal oversight, we will

conduct a credit check.

You hereby authorize the obtaining of such consumer reports and investigative consumer reports at any time after execution of this authorization.

By signing below, you hereby authorize without reservation, any party or agency contacted by this employer, or the consumer reporting agency

acting on behalf of the employer, to furnish the above mentioned information. You also agree that a fax or photocopy of this authorization with your

signature shall be accepted with the same authority as the original.

For California, Minnesota, or Oklahoma applicants only, if you would like to receive a copy of the consumer report, if one is obtained, please check this box.

For California applicants only, if public record information is obtained without using a consumer reporting agency, you will be supplied a copy of the public

record information unless you check this box waiving your right to obtain a copy of the report.

ALL fields below are REQUIRED

Printed name of applicant/employee:

Exactly as it appears on current driver’s license

First

Last

M I

Social Security Number

Date of birth

Gender

Current address

Street address