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Free form template · Word

Background Check Authorization

A background check authorization is the standalone consent document a candidate signs to permit employment screening. It explains which checks will be run, who will run them, how the data will be used and stored, and the candidate's right to explain any adverse finding, making the consent informed and specific.

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[Company Logo][Company Name]

AUTHORISATION FOR BACKGROUND VERIFICATION

Company:
[Company Name]
Candidate Name:
[Candidate Name]
Position:
[Designation]
Date:
[Date]

1. Purpose

[Company Name] conducts background verification of selected candidates to confirm that the information they have shared is accurate and to maintain a safe and trustworthy workplace. Your offer of employment is subject to satisfactory completion of these checks.

2. Scope of Checks I Authorise

  • Identity verification
  • Current and permanent address verification
  • Education and professional qualification verification
  • Previous employment verification (designation, dates, conduct)
  • Professional reference checks
  • Criminal / court record check (only where required for the role)
  • Credit / database check (only where required for the role)

3. Verification Agency

The checks may be carried out by [Company Name] directly or through its authorised agency, [Agency Name], [Agency Address]. The agency is bound to keep my information confidential.

4. Use and Protection of Information

  1. My information will be used only for verifying my suitability for employment.
  2. It will be shared only with the agency and the institutions, employers and authorities needed for the checks.
  3. Records will be kept securely for [Period] and then deleted as per company policy.
  4. If any adverse finding arises, I will be informed and given an opportunity to explain before a final decision is taken.

5. Authorisation

I, [Candidate Name], have read and understood this authorisation. I voluntarily authorise [Company Name] and [Agency Name] to conduct the checks marked above and authorise the named institutions, employers and references to release relevant information. A photocopy or scanned copy of this authorisation is as valid as the original. I may withdraw this authorisation by writing to [Email], understanding that my offer may depend on completion of verification.

Candidate Name
Date of Birth
PAN
Place
Candidate Signature
[Candidate Name]
Date: [Date]
Witnessed by HR
[HR Name]
Date: [Date]

What this template includes

  • Plain-language explanation of the purpose
  • Specific list of checks the candidate agrees to
  • Name of the verification agency, if used
  • How data will be stored, shared and retained
  • Candidate's right to review and explain findings
  • Validity of the authorisation and withdrawal process
  • Signature with date and place

When to use it

  • Before sharing candidate data with a third-party BGV agency
  • When institutions or past employers ask for proof of consent
  • Re-verification of existing employees moving into sensitive roles
  • Alongside a BGV form that does not have detailed consent wording

How to customise this template

  1. 1Insert the BGV agency name and contact
  2. 2Remove checks that do not apply to the role
  3. 3Set the retention period according to your data policy
  4. 4Provide the form in a language the candidate understands

HR tips

  • Make the scope specific; 'any checks we see fit' is not informed consent
  • Give the candidate a copy of the signed authorisation
  • Run criminal or credit checks only for roles where they are relevant
  • Keep authorisations on file for as long as the verification records

This template is a starting point. Review the consent, data-retention and withdrawal wording against applicable laws, including India's data-protection rules, and with a legal adviser where needed.

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Frequently asked questions

Why is a separate background check authorization needed?+

It documents specific, informed consent for each type of check and for sharing data with a verification agency, which many institutions and agencies require.

Can a candidate refuse to sign the authorization?+

Yes, but if verification is a condition of the offer, the company may be unable to proceed. State this clearly and respectfully.

Can consent be withdrawn later?+

The candidate can write to HR to withdraw consent; checks already completed are not reversed, and the offer may depend on verification.