These sample forms or those approved by your counsel and submitted to SecurTest must be used when ordering background reports. (See below.)
DISCLAIMER: The links and forms herein may help you and your counsel comply with various federal and state regulations and understand common terms. 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, responsibility or damages associated with or arising from the information provided. Employers seeking credit reports must provide additional notices and obtain approval and certification from SecurTest. 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 to be given to the candidate before a background check or consumer report is ordered. These resources are valuable examples of navigational tools and resources to assist you and your counsel. 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.
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, unless you wish to use our secure online form. If so, then use form Option 1.
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, and
3). The client code was emailed with your login
information.
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).
OPTION 1 - CANDIDATE OR SUBJECT OF REPORT USES THE ONLINE AUTHORIZATION
FORM
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A. SecurTest Online Authorizaton and Notices. (Automates the correct notices and forms) 1. Send the candidate an email, such as the following example. You will need to fill in the bracketed fields [ ] including your company name, SecurTest Client Code, your email address, and the Unique Code. The Unique Code is STI20190320 SAMPLE EMAIL Dear Candidate, The next step is for you to complete the SecurTest Background Check. You must begin this important step within 2 business days. Write the following information down, as you will need it to get started.
Follow these simple steps, as the faster you complete the forms from your computer, tablet or cell phone, your report can be completed in the time required.
STEPS THE CANDIDATE TAKES 1. Once your candidates complete the form, they and you will receive an email with the completed authorizations and notices. 2. This vital step helps them have confidence that the FCRA, various state and local laws are being followed.
NEXT STEPS YOU TAKE 1. You will receive an email with the completed Authorization forms and notices. Save the attachment or email as evidence of their authorization and consent. 2. Open the attachment using the password provided in the email. 3. There will be a Reference Number in the email and on the attached PDF file. 4. Login to SecurTest and select REQUEST to order the background report. 5. Select the package and enter (copy and paste) the Reference Number and all the information about the candidate. 6. YOU DO NOT NEED TO UPLOAD THE FORM, as our system stored it when the candidate completed it. You MUST then order online the background check at SecurTest.com. |
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OPTION 2 - CLIENT DOWNLOADS AND/OR PRINTS AUTHORIZATION FORMS | |||||||||||||||||
1. DOES NOT live in
California, New York, New Jersey, Washington, Wisconsin, Vermont, Minnesota,
or Massachusetts.
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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.
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Click Here | ||||||||||||||||
3. CURRENTLY resides in the City of
Los Angeles, California.
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Click Here | ||||||||||||||||
4. CURRENTLY resides in the City of
San Francisco, California.
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Click Here | ||||||||||||||||
5. CURRENTLY resides in the state of
New York, but not in New York City.
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Click Here | ||||||||||||||||
6. CURRENTLY resides in New York
City, New York, including Manhattan, Brooklyn, Queens, The Bronx, and Staten
Island.
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Click Here | ||||||||||||||||
7. CURRENTLY resides in New Jersey.
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Click Here | ||||||||||||||||
8. CURRENTLY resides in Vermont.
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Click Here: | ||||||||||||||||
9. CURRENTLY resides in
Massachusetts.
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Click Here | ||||||||||||||||
10. CURRENTLY resides in the state of
Washington
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Click Here | ||||||||||||||||
11. CURRENTLY resides in Wisconsin
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Click Here | ||||||||||||||||
12. CURRENTLY resides in Minnesota
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Click Here |
USE THESE FORMS IF HAVING TROUBLE PRINTINGTHE FORMS ABOVE (ADOBE VERSION 5) |
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1A. DOES NOT live in
California, New York, New Jersey, Washington, Wisconsin, Vermont, Minnesota,
or Massachusetts.
|
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2A. CURRENTLY resides in
California, BUT NOT in the cities of Los Angeles or San
Francisco.
|
Click Here |
3A. CURRENTLY resides in the City of
Los Angeles, California.
|
Click Here |
4A. CURRENTLY resides in the City of
San Francisco, California.
|
Click Here |
5A. CURRENTLY resides in the state of
New York, but not in New York City.
|
Click Here |
6A. CURRENTLY resides in New York
City, New York, including Manhattan, Brooklyn, Queens, The Bronx, and Staten
Island.
|
Click Here |
7A. CURRENTLY resides in New Jersey.
|
Click Here |
8A. CURRENTLY resides in Vermont.
|
Click Here |
9A. CURRENTLY resides in
Massachusetts.
|
Click Here |
10A. CURRENTLY resides in the state
of Washington
|
Click Here |
11A. CURRENTLY resides in Wisconsin
|
Click Here |
12A. 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.
New York City Notice Additional Forms MVR (Motor Vehicle
Record) – Driving Record Authorization |
Which states restrict reporting on convictions?
Under the FCRA, convictions can appear on a background report regardless of when they occurred. However,
some states have limited the scope of conviction reporting to seven years, including California, Kansas,
Maryland, Massachusetts, Montana, New Mexico, New York, New Hampshire, and Washington. However,
federal law, such as the FDIC for banking access, have restrictions that supersede state laws.
Which states restrict reporting on non-convictions?
Under the FCRA, non-convictions are reportable for seven years from the file date and can appear on a
background report for seven years. Some states entirely prevent non-convictions from being reported.
These states are California, Kentucky, New York, and New Mexico. Below is a non-exhaustive list of other
state-specific and industry-specific considerations.
• California:
◦ Marijuana Misdemeanors: Non-Felony (Misdemeanor) convictions for marijuana possession can only be reported for 2 years from the disposition date. Furthermore, end users (employers) are also prohibited
from seeking or considering this information when making employment decisions.
◦ Transportation Networks (TNC): Regulatory exception under AB1289 allows consumer reporting
agencies to report convictions beyond 7 years when preparing reports for TNCs. Under this regulatory
reporting exception, TNCs can see convictions for CA applicants regardless of when they occurred.
• Maryland:
Transportation Networks (TNCs) are required to search the "entire adult history" of candidates for TNC roles.
• Kentucky: Pending criminal cases are never reportable.
• Salary exceptions: Some states provide salary exceptions, allowing convictions to remain reportable
for candidates who expect to make over $20,000 ($25,000 in New York).Other location-specific laws should be considered
Keep in mind, however, that states and municipalities also have specific laws regarding how end
users and employers use and consider criminal records during an employment pre-screening process. The
laws include individualized assessment of offenses, “Ban the Box,” salary bans, permissible purposes for employment credit checks, disclosure and authorization, and waiting periods for adverse action notices. Here are some cities that have additional legal mandates:
City of Los Angeles Notice
City of San Francisco Notice
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.
DISCLAIMER: The links and forms herein will help you and your counsel comply with 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 the 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 to be given to the candidate before a background check or consumer report is ordered. These "draft" resources are provided 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.
NEW SETUP INSTRUCTION: Complete the "CLIENT CERTIFICATION" one time for the company (end-user). (See footnote 1 below.)
This form does not need to be completed each time you order a background check. CLIENT SETUP Form: Click Here
Custom Forms and Links
Upload Files Here to SecurTest: Click Here
ISS School Registration Page - Click Here
ISS Background Check - Click Here
University of Florida Shands Authorization - Click Here
SecurTest Client Online Background Check (Must Have Client Code) - Click Here
Enter Your FBI Fingerprint Tracking Number - Click Here
Q1. Current QSI Employee - USA Passport Holder (FBI and Commercial Check - Click Here
Q2. Current QSI Employee - Non-USA Passport Holder - Click Here
Q3. New QSI Employee - USA Passport Holder - Click Here
SecurTest Consumer Authorization for Search Associates - Click Here
ISSREV - SecurTest Consumer Authorization for ISS - Click Here
Get a Free Quote - Click Here
Background Check 21 Registration - Click Here
Background Check 21 Subscriber Agreement - Click Here
iReviewNow Patented Assessment - Click Here
iReviewNow for ISS - Click Here
iReviewNow for QSI - Click Here
Identity Validation - Click Here
SecurTest Authorization for FBI Background / International Background - Self Pay - Click Here
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 SecurTest's notice.
Rev. 06.26.2024