Client and Applicant Instructions Canada
Client and Applicant Instructions Canada
Client and Applicant Instructions Canada
Canada
For CRIMINAL RECORD REPORTS, the applicant will have to follow the instructions below:
1.
2.
Please complete and sign the Special Letter of Authority (form attached).
Please note that applicants are required to provide a physical residential
address in Canada.
Please be aware that international background checks often take longer than checks done in
the United States.
Verifications Inc.
1425 Mickelson Drive
Watertown, SD 57201
Tel: +1 605 884 1200 Fax: +1 605 884 1140
Canada-AplInstr-2012-05-29
[Please mark the boxes for the categories you are authorizing Verifications to obtain. Leave any box you ARE NOT
consenting to blank as any mark will be considered evidence of consent.]
__Academic/Education
__Credit/Financial/Bankruptcy
__Criminal History
__Address Verification
__Professional
License
__References
__Driving Record
__Government Databases
__Media Search
__Employment
__Other:
__Executive Affiliations
__Identity Verification
I understand that a Consumer Report may be prepared summarizing information from these categories and I authorize educational institutions,
employers, government agencies, credit reporting agencies, companies, corporations, and law enforcement agencies at the international, federal,
state/provincial or county level to provide any and all information concerning my background. If my prior employers and/or references are contacted,
the Consumer Report may include information obtained through personal interviews regarding my character and general reputation. I understand
that the personal information described above is being collected, used and disclosed only for the purposes of assessing my suitability for
employment with the above-named company.
I may request a copy of any report that is prepared regarding me and A Summary of Your Rights under the Fair Credit Reporting Act. I may also
request the nature and substance of all information about me contained in the files of the consumer-reporting agency. I understand I have the right to
inspect those files with reasonable notice during regular business hours and I may be accompanied by one other person. I understand that I have the
right to dispute any information contained in the consumer report, if I believe it is false, inaccurate or misleading. The consumer-reporting agency is
required to provide someone to explain the contents of my file. I understand proper identification will be required and I should direct my request to:
Verifications, Inc., Applicant Services Department, 1425 Mickelson Drive, Watertown, SD 57201, USA. Phone 1-800-247-0717 / +1 605-8841200. For a copy of Verifications privacy practices, visit http://www.verificationsinc.com/eng/privacy.cfm.
This consent is effective from the date specified on this form until the date my employment application is accepted or denied by the above-named
company, or until I withdraw my authorization in writing. I acknowledge and agree that a photocopy of this authorization may be accepted with the
same authority as the original.
I authorize Verifications, Inc. to prepare a Consumer Report/Investigative Consumer Report on me, and I authorize the above-named
company to procure a Consumer Report/Investigative Consumer Report about me from Verifications, Inc.
Signature
[Note to applicant: Please complete and submit the information requested on the following page. It will be used prepare your Consumer
Report and IS NOT considered as part of your application for employment or continued employment.]
Page 1 of 2
Street Address
State/Province
City
Country
ZIP/Postal Code
Page 2 of 2
Position
My Personal Details
Full Legal Name (no abbreviations; please include all surnames)
Place of birth
(day/month/year)
Sex (M/F)
Previous addresses in Canada are REQUIRED (post office boxes are not acceptable):
1.
Street Address
City
Dates of Residence
Province/Territory
(day / month/ year)
to
Dates of Residence
Postal Code
(day / month/ year)
2.
Street Address
City
Dates of Residence
Province/Territory
(day / month/ year)
to
Dates of Residence
Postal Code
(day / month/ year)
3.
Street Address
City
Dates of Residence
Province/Territory
(day / month/ year)
to
Dates of Residence
Postal Code
(day / month/ year)
The information is only to be used for the job application and CANNOT be used for any other purpose and
MUST be destroyed within the time required by the law. I certify that I am the person identified in this
authorization.
Applicants Signature
Date
Verifications Inc.
1425 Mickelson Drive
Watertown, SD 57201
Tel: +1 605 884 1200 Fax: +1 605 884 1140
Canada-CD-LOA 2012-05-29.doc