AUTHORIZATION TO CONDUCT A BACKGROUND INVESTIGATION
I hereby authorize __________________________ to make inquiries, either by
written communication, by telephone, online, or in person to any present or
former employer, creditor, credit bureau, government agency, educational
institution, military establishment or any other persons or institutions
knowledgeable of my background as to my prior history, work experience, nature
of duties, work hours, wages, performance levels, reliability, responsibility,
honesty and any other measures of my character or personality.
In consideration for your developing such information, I specifically waive any
confidential relationship of privacy position which may exist between us and
completely release you from any responsibility or liability for damages which
may occur as a result of the disclosure of this information.
A photostatic, or any other copy, of this instrument bearing my signature shall
be equally legally valid as the original.
DATE _____________________________________
PRINTED NAME ______________________________
SIGNATURE _________________________________
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