This is a sample only. It can be adapted to your organization's practices. It is strongly recommended that any form you create for applicants to sign receive a final review by legal counsel to ensure it complies with current employment laws (including state law, if applicable) and is defensible under the law.
If ongoing background checks will be conducted, that should be clearly stated in the acknowledgment and authorization notification as well.
Hire with confidence! MRA has all the reference & background investigation resources you need!