Sapphire Security Services

Veteran-Led Security · sapphiresecurity.us

Background Check Authorization & Consent

Pursuant to the Fair Credit Reporting Act (FCRA), 15 U.S.C. § 1681 et seq.

Applicant Information

Full Legal Name

Date of Application

Date of Birth

Social Security Number

Driver's License #

Current Address

City, State, ZIP

Other Names Used (Maiden, Aliases)

Disclosure Statement

Sapphire Security Services ("Company") may obtain a "consumer report" (background report) and/or "investigative consumer report" (which may include information about your character, general reputation, personal characteristics, and mode of living) about you from a consumer reporting agency ("CRA") for employment purposes, including your potential hire, retention, promotion, reassignment, or termination.

An investigative consumer report includes information obtained through personal interviews with your neighbors, friends, associates, former employers, and others. You have the right to request that the Company provide you with additional information about the nature and scope of any investigative consumer report, and you may request a copy of your rights under applicable law.

Authorization

By signing below, I hereby authorize Sapphire Security Services and its designated agents and representatives to conduct a comprehensive review of my background. This authorization shall include, but not be limited to, the following:

Criminal History: Local, state, and federal criminal records; sex offender registry; terrorist watch lists

Employment Verification: Verification of dates of employment, job titles, and eligibility for rehire at all listed employers

Education Verification: Verification of degrees, diplomas, and certificates claimed

Professional Licenses: Verification of any professional licenses or certifications claimed, including security guard licenses

Motor Vehicle Records (MVR): If driving is a requirement of the position

Military Service Records: Verification of service dates, discharge status, and rank if applicable

FCRA Rights Notice

You have the right to request a free copy of your consumer report from the consumer reporting agency if adverse employment action is taken. You have the right to dispute the accuracy or completeness of any information in your report. A copy of "A Summary of Your Rights Under the Fair Credit Reporting Act" is available upon request.

State-Specific Notices

If you reside or work in California, Minnesota, Oklahoma, or certain other states, you may have additional rights. Consult applicable state law or request additional information from our HR department.

I understand that this authorization will remain on file and may be used as a basis for requesting periodic background reports throughout my employment, where permitted by law.

Applicant Signature

Signature (Sign in ink)

Date Signed

MM / DD / YYYY

This form is for use by Sapphire Security Services. For questions, contact: trevor@sapphiresecurity.us · sapphiresecurity.us · Las Vegas, NV