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Get Blank Background Check Consent Form

Extended Background Check EBC Authorization Form CONSENT TO PERFORM CRIMINAL HISTORY BACKGROUND CHECK IN COMPLIANCE WITH THE FCRA FAIR CREDIT REPORTING ACT Date Last Name Middle Name First Name Maiden and/or Other Last Names Used Address Phone Number City State Zip Code List last two Counties that you lived in Date of Birth Social Security Number Circle One Male Female This authorization and consent for release of personal information acknowledge.

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