WP E-Signature by Approve Me - Sign Documents Using WordPress -

Employment Applicant Disclosure and Release Form

As part of the application process for Employment hiring purposes from Technology Visionaries LLC, I understand that they and/or its agents may conduct an investigation of my personal information. The investigation might include, but is not limited to names and dates of previous/current addresses and/or employment, database search, criminal history records from state, federal and other agencies, bankruptcy records, and credit history. I understand that these records may be used for the eligibility of my employment application. I authorize without reservation the full release of these records for SARMA and/or its agents to obtain information.

I also authorize the full release of the information described above, without any reservation, on behalf of this application for employment and if hired throughout the duration of my employment. I also certify that all information provided is correct on the application to the best of my knowledge. Any false statements provided will be considered just cause for termination of my employment.

SARMA will upon request, supply a copy of the credit report and my rights under the Fair Credit Reporting Act. SARMA can be reached at 1-800-955-5238.

Credit/Criminal/Verification Release Authorization

I hereby authorize SARMA to obtain a credit report in connection with my application at Technology Visionaries LLC. I understand that my credit report and the information therein shall be used in compliance with the Fair Credit Reporting Act or appropriate regulations. I also understand that I have a right to obtain a copy of my own credit report and can dispute any information.

I, hereby authorize, without any reservation, any bureau contacted by SARMA to obtain the above credit information.

Applicant (Last Name) (First Name) (Middle Initial)

Applicant (Maiden Name/Former Name)

Cell Phone Number

Current Address, City and Zip Code

Move In Date

Former Address, City and Zip Code (or use this line if Co-Applicant current address is different from above

Move In Date Move Out Date

Social Security Number Date of Birth

Driver License Number State of Issue

Current/Previous Employment

Employer Contact Name/Number

Employment Dates Position/Income

Current/Previous Employment

Employer Contact Name/Number

Employment Dates Position/Income

Current/Previous Employment

Employer Contact Name/Number

Employment Dates Position/Income

Education Verification

School Name School City & State

School Contact Name/Number

Previous Name (maiden name)

Dates Attended

Degree Claimed

Major

School Name

School Contact Name/Number

Previous Name (maiden name)

Dates Attended

Degree Claimed

Major

Please indicate your approval and sign below:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Timestamp

Audit

February 8, 2020 11:42 am EDT

Employment Applicant Disclosure and Release Form Uploaded by AJ Gyomber - aj@technologyvisionaries.com IP 96.93.143.169