Albion Legal Staffing Solutions

	We're BIG on Quality!
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Pre-Employment Screening Report:

Report(s) requested - Highlight all those that are applicable:

	Social security number validation
	Credential Verification
	Education Verification
	County felony criminal history check (up to 3 Counties per applicant)
	Driving Record
	Credit Record
	Criminal Records Employment Reference Check
	Personal Reference Check
	Workers' Compensation Claim

Person/Company ordering Report:

Name:
Company:
Email:

Release Authority required from Candidate:

I hereby approve Albion Legal Solutions to obtain background report on myself with the understanding that this information will not be used for any other purpose than pursuant to either a permanent or temporary employment opportunity with a prospective employer. My approval to run a Background Check hereby grants authority to Albion and its nominated investigation agency to contact past employers, educational institutions, credit reporting and law enforcement agencies to obtain and release relevant information. I also hereby agree that this on-line Release Authority shall be as valid as an original signed document.

Click here if you do NOT want a Background Investigation Report run:
Click here to release your specific approval to have a Background Investigation Report run:

If you release your specific approval to have a Background Investigation Report run, please complete the following:

Your full name:	Last:
	First:
	Middle:
Any other names used or known by:
Current Address:	Street:
	City:
	State:
	Zip:
	County:
Telephone:
Email:
Previous address (if less than 5 years)	Street:
	City:
	State:
	Zip:
	County:
Date of Birth: (Month/Date/Year):
Drivers License:	Number:
	State:
Social Security Number:
Gender:	Male: Female:
Race:	Black: White: Hispanic: Other:

This authorization shall be valid for a period of 3 months:

Please type your full name (in lieu of signature)
Date: (Month/Date/Year)

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All services are undertaken in the strictest of confidence and our clients can be assured of a highly discreet and confidential service.