Applicant Disclosure and Authorization Form for Background Checks
This document provides disclosure and authorization for background checks conducted by One Source for OSCC site access. It includes information on ongoing screening and California residents' rights. It is important to read this document carefully before signing the authorization.
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How do I fill this out?
To fill out this form, gather all required personal information. Ensure all details are authentic and up-to-date to avoid delays. Read the disclosure and authorization sections thoroughly.

How to fill out the Applicant Disclosure and Authorization Form for Background Checks?
1
Gather all pertinent personal information.
2
Carefully read the disclosure and authorization sections.
3
Fill in the necessary fields with accurate details.
4
Ensure no required fields are left blank.
5
Sign and date the form where indicated.
Who needs the Applicant Disclosure and Authorization Form for Background Checks?
1
Job applicants required to undergo background checks.
2
Employees participating in OSCC programs for site access.
3
Individuals needing recurring screening for ongoing site access.
4
California residents needing to understand their background investigation rights.
5
Employers coordinating background checks for their workforce.
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What are the instructions for submitting this form?
To submit the completed form, follow the instructions provided by the requesting entity. This may include sending it via email, fax, or to a specified physical address. For One Source, you can mail it to One Source The Background Check Company, PO Box 24148, Omaha, NE 68124, or fax it to 1.800.608.3645. Ensure all fields are filled out accurately and legibly to avoid any processing delays.
What are the important dates for this form in 2024 and 2025?
Important dates for this form in 2024 and 2025 include the dates of program participation commencement and renewal periods. Ensure to submit the form promptly to avoid delays in site access or program participation.

What is the purpose of this form?
The purpose of this form is to provide disclosure and authorization for background checks by One Source for OSCC site access. It informs applicants about the nature of the background investigation, including consumer and investigative reports that might be obtained. Additionally, it outlines the ongoing screening process and the rights of California residents regarding their background information.

Tell me about this form and its components and fields line-by-line.

- 1. Last Name: The applicant's last name.
- 2. First Name: The applicant's first name.
- 3. Middle: The applicant's middle name.
- 4. Other Names/Alias: Any other names or aliases used by the applicant.
- 5. Social Security #: The applicant's social security number.
- 6. Date of Birth (MM/DD/YYYY): The applicant's date of birth in MM/DD/YYYY format.
- 7. Driver's License #: The applicant's driver's license number.
- 8. State of Driver's License: The state that issued the applicant's driver's license.
- 9. Present Address: The applicant's current address.
- 10. City: The city of the applicant's current address.
- 11. State: The state of the applicant's current address.
- 12. Zip: The zip code of the applicant's current address.
- 13. Phone: The applicant's phone number.
- 14. All Previous Addresses in the Last Seven (7) Years: The applicant's addresses for the past 7 years.
- 15. Signature: The applicant's signature.
- 16. Date: The date when the form was signed.
What happens if I fail to submit this form?
Failure to submit this form can lead to significant consequences. It is crucial to complete and send the form promptly to ensure compliance and access as required.
- Denial of Site Access: Failure to submit may result in being denied access to OSCC sites.
- Program Ineligibility: Incomplete forms may lead to ineligibility for OSCC program participation.
- Non-Compliance with Background Requirements: Not submitting the form can result in failure to meet minimum background requirements set by the companies.
How do I know when to use this form?

- 1. Employment Background Checks: Required for job applicants needing background verification.
- 2. OSCC Program Participation: Needed for individuals participating in OSCC programs for site access.
- 3. Ongoing Screening: Used for recurring background checks during the course of participation.
- 4. California Residents: For California residents to understand their rights in background investigations.
- 5. Employer Background Verification: Employers use this form to coordinate background checks for compliance.
Frequently Asked Questions
How do I fill out the background check authorization form?
Gather all required personal information, read the disclosure sections carefully, fill in the fields accurately, sign, and date the form.
Can I edit the PDF form on PrintFriendly?
Yes, you can upload the document to our PDF editor, make necessary changes, and save the edited version.
How can I sign the PDF on PrintFriendly?
Use our integrated signature tool to apply your digital signature to the document after uploading it.
Who needs to use this form?
Job applicants, employees in OSCC programs, individuals needing recurring screening, California residents, and employers coordinating checks.
What happens if I fail to submit this form?
Failure to submit may result in denial of site access, ineligibility for program participation, or inability to verify compliance with background requirements.
How do I know when to use this form?
Use this form when you are required to undergo a background check for employment, site access, or ongoing screening as per OSCC program requirements.
What information is required for this form?
You need to provide personal information such as name, address, social security number, driver’s license number, and previous addresses.
Can California residents access their background check information?
Yes, California residents can request access to their files maintained by investigative consumer reporting agencies under California law.
What is the purpose of this form?
The form discloses and authorizes background checks by One Source for OSCC site access and provides information on ongoing screening and rights.
How do I submit the completed form?
Submit the completed form via the specified channel provided in the instructions, which may include email, fax, or physical address.
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