Employment Background Screening Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Employer Name & Point of ContactName *FirstMiddleLastJr/Sr/III and nicknames usedEmail *Current Street Address -Please list 7 (seven) years of home addresses. Please include street,, city, state and zip code Previous Address #2Please include street,, city, state and zip code Previous Address #3Please include street,, city, state and zip code Previous Address #4Please include street,, city, state and zip code Date of BirthSocial Security / ID *Driver's License Number & Issue StatePhone NumberCriminal HistoryDo you currently have criminal charges pending against you?YesYesNoHave you ever been convicted of a crime? YesYesNoIf you have been convicted of a crime please provide details:Work HistoryMost recent employerPrevious employer #1Previous employer #2Previous employe #3Previous Employer #4Previous Employer #5Screening AgreementYou authorize TNG Security and any third-party consumer affiliate reporting agency, for employment screening purposes, and retention as an employee, at any time prior to or during your employment, if applicable, and without giving you any further notice. You may be the subject of a background check, also known as a “consumer report” and/or an “investigative consumer background report,” which may include information about your character, general reputation, personal characteristics, and/or mode of living. These reports may contain, without limitation, all or some of the following types of information about you: social security number verification, address and alias history, personal references, professional references, employment history, educational/school history, licenses, certifications, motor vehicle records, driving records, criminal history, and civil court record history. Credit history will only be requested where such information is substantially related to the duties and responsibilities of the applied-for position. You have the right to know whether a consumer report has been obtained about you; and you have the right to request a copy of any report obtained by Company, a copy of “Summary of Your Rights Under the FCRA,” and a complete and accurate written disclosure of the nature and scope of any investigative consumer report obtained by Company. An investigative consumer report is information on an individual's character, general reputation, personal characteristics, or mode of living is obtained through a personal interview with an information source. E-Sign to Continue: *NamePAYMENTCoupon Apply Multiple ItemsRegular 2 Business DaysRush 24 HousSuper Rush – Same DayTotal *$0.00Square *CardName on CardSignature Clear Signature Submit
