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Compliance Documents

These sample forms or those approved by your counsel and submitted to SecurTest must be used when ordering background reports. (See below.)


1. Before you order the background screening online you will need to generate the Required Disclosure and Authorization forms and State or City notices below for each candidate.

2. If your candidate is NOT currently residing in California, New York, New Jersey, Washington, Wisconsin, Vermont, Minnesota, or Massachusetts, you will select form # 1 by clicking “Click Here” in the column to the right.  

NOTE: Select the Click Here button to the right to open the document.

***REQUIRED*** Fill in your organization name and SecurTest Client Code on page 1.  Go to Step 4.


3. If your candidate is currently residing in California, New York, New Jersey, Washington, Wisconsin, Vermont, Minnesota, or Massachusetts, there is an additional Notice that will be included with the Disclosure and Authorization forms. Please review the States and Cities below and determine which authorization and notice packet you will need depending on the State or City your candidate is currently residing in.

4. Next you will have the candidate complete and sign each page where indicated. 

5. This must be completed with every background check order. You MUST give all applicable notices and authorizations to the candidate. 

6. Now you are ready to order the background screening online. You must upload ALL PAGES when ordering the background check online, including the FCRA Summary of Rights, and all State or City Notices that apply to the candidate's current residence.

(We must have the company or organization name and client code filled in on page 1, and signatures where indicated, such as pages 1, 2, 3, and 4.

Use this step if you are having trouble printing a completed form. After you’ve filled out a PDF form in Preview, choose Print from the File menu and then use the dialog box’s PDF option to save it to a PDF.
Visit the Adobe website to download the latest version of Adobe Reader, if you don't already have it. Visit the website of the manufacturer of your printer and download an updated printer driver, if one is available. You can also go into the Print Dialogue (Ctrl+P) and beneath the Properties button, select "Documents and Markup" from the drop-down options ("Documents" was the default). 


Complete the "CLIENT CERTIFICATION" once and send us only pages 1 to 4 each time you order a background report. You save the notices and forms provided to each candidate. (See footnote 1 below.)
Click Here
1. DOES NOT live in California, New York, New Jersey, Washington, Wisconsin, Vermont, Minnesota, or Massachusetts.
Can't View or Print - Scanned PDF version Click Here
Can't View or Print - Scanned Word version Click Here
2. CURRENTLY resides in California, BUT NOT in the cities of Los Angeles or San Francisco.
Click Here
3. CURRENTLY resides in the City of Los Angeles, California.
Click Here
4. CURRENTLY resides in the City of San Francisco, California.
Click Here
5. CURRENTLY resides in the state of New York, but not in New York City.
Click Here
6. CURRENTLY resides in New York City, New York, including Manhattan, Brooklyn, Queens, The Bronx, and Staten Island.
Click Here
7. CURRENTLY resides in New Jersey.
Click Here
8. CURRENTLY resides in Vermont.
Click Here:
9. CURRENTLY resides in Massachusetts.
Click Here
10. CURRENTLY resides in the state of Washington
Click Here
11. CURRENTLY resides in Wisconsin
Click Here
12. CURRENTLY resides in Minnesota
Click Here

Helpful Link - Helps you determine if candidate resides in a particular City. (Enter Zip Code) - If the candidate puts a particular State or City on his or her application as the current residence, use the correct authorization and form listed above.

Click Here for the latest version of Adobe Reader.



Place your mouse over the "Form/Link" and RIGHT-CLICK then select Download Linked File. The file will be saved on your computer. Open the file. Allow Javascript to be used with the form.
on your computer.

New York City Notice

New York City "Second Chance" Law
New York City "Fair Chance Form" Employers must complete this form and provide it to the subject if adverse action is taken.
New York State Notice

New Jersey Summary of Rights
Massachusetts Notice
State of Washington Summary of Consumer Rights Notice
City of San Francisco Notice
City of Los Angeles Notice
California Notice Regarding Background Checks
Wisconsin Notice
Minnesota Notice
Vermont Notice

FCRA Summary of Rights

Additional Forms

MVR (Motor Vehicle Record) – Driving Record Authorization
Must be signed by the candidate and uploaded when ordering an MVR check.
Employment Verification Authorization
Must be signed by the candidate and uploaded when ordering Employment Verifications.
Education Verification Authorization
Must be signed by the candidate and uploaded when ordering an Education Verification.
Using Consumer Reports: What Employers Need to Know
What you must know about Consumer Reports and Consumer Reporting Agencies.
Credit Freeze Notice
Notice to be given to consumers inquiring about freezing their credit file.
Full Authorization Form with all notices
Same as #1 with the State and NYC notices,  education, employment, and MVR authorizations.
User Guide
How to order and view SecurTest Background Reports.
Credit Check Authorization
Must be signed by the candidate and uploaded when ordering a credit report. (SecurTest approval required.)

DISCLAIMER: The links and forms herein will help you and your counsel comply with various federal and state
regulations and understand common terms. The Resources Page is exclusively provided to our clients. The contents,
forms, and sample documents should NOT be construed as legal advice, guidance or counsel.
Users should consult their own attorney about their compliance responsibilities under the FCRA and applicable state
and local laws. SecurTest, Inc. expressly disclaims any warranties or responsibility or damages associated with or
arising out of information provided. Employers seeking credit reports must provide additional notices pursuant to
state law. The various forms may require that you enter an authorized PASSWORD, which is case sensitive.
Federal and various state laws require specific notices and disclosures be given to the candidate before a background
check or consumer report is ordered.

These resources are provided to you to serve as valuable navigational tools and resources to assist you. This information is intended for general educational and informational purposes only and is not legal advice, expressed or implied. If you need legal advice, consult with a qualified, licensed attorney.

Footnote 1: By completing the Client Certification, we agree that pursuant to the SecurTest Professional Services Agreement and various federal, state and local laws, we hereby certify to SecurTest, Inc. that we will provide to any candidate or subject the applicable notices before ordering a background report. Pursuant to your services agreement and federal, state and local laws, you are required to use and save the correct authorizations, notices, and forms. These notices, forms and authorization may be updated from time-to-time without notice by SecurTest

Rev. 02/18/2019 16:24

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