After carefully reading this Background Check Disclosure and Authorization form, I authorize California Intelligence Agency to procure a background check report on me and drug test scheduled. I understand that, if I am hired, California Intelligence Agency may rely on this authorization to procure additional background check reports during and throughout my employment without asking for my authorization again.
I also authorize the following entities to disclose to the consumer reporting agency and its agents all information about or concerning me, including, but not limited to: my past or present employers; learning institutions, including colleges and universities; law enforcement and all other federal, state and local agencies; federal, state and local courts; the military; credit bureaus; testing facilities; motor vehicle records agencies; all other private and public sector repositories of information; and, any other person, organization or agency with any information about or concerning me. The information that can be disclosed to the consumer reporting agency and its agents includes, but is not limited to, information concerning my employment history, earnings history, education, credit history, motor vehicle history, criminal history, drug test results, military service, professional credentials, and all other information requested by the consumer reporting agency or its agents.
The types of information that may be obtained include but are not limited to: social security number verification; criminal, public, educational and, as appropriate, driving records checks; verification of prior employment; references checks; credit reports; licensing and certification checks; and drug testing results. The information will be obtained from private and public record sources, including in some circumstances interviews with your associates, friends and neighbors.
I promise the information I provided on this form is true and correct. I understand that dishonesty will disqualify me from consideration for employment with the Company, or if I am hired, that I may be terminated.
