Background Check Affidavit

I, [Your Name], in my capacity as [Your Title] at [Your Company Name], located at [Your Company Address], do hereby affirm the accuracy of the information provided by [Applicant's Name], hereinafter referred to as the "Applicant," in this Background Check Affidavit.

Applicant's Personal Information:

Full Name: [Applicant's Name]
Date of Birth: [Applicant's Birthdate]
Social Security Number: [Applicant's SSN]
Current Address: [Applicant's Address]
Contact Number: [Applicant's Number]
Email Address: [Applicant's Email]

Employment History:

Company Name: [Employer 1]
Address: [Employer Address]
Position Held: [Your Position]
Dates of Employment: [Start Date] to [End Date]
Reason for Leaving: [Reason]
Company Name: [Employer 2]
Address: [Employer Address]
Position Held: [Your Position]
Dates of Employment: [Start Date] to [End Date]
Reason for Leaving: [Reason]

Educational Background:

School/College Name: [Institution Name]
Address: [Institution Address]
Degree Obtained: [Degree]
Major/Field of Study: [Major/Field]
Dates of Attendance: [Start Date] to [End Date]

Criminal History [if applicable]:

[List any criminal convictions.]

Driving Record [if applicable]:

[List any traffic violations, suspensions, or revocations of driver's license.]

References:

Professional Reference 1:

Name: [Reference Name]
Position: [Reference Position]
Company/Organization: [Reference Company/Organization]
Contact Information: [Reference Email]

Professional Reference 2:

Name: [Reference Name]
Position: [Reference Position]
Company/Organization: [Reference Company/Organization]
Contact Information: [Reference Email]

I hereby certify that the information provided by the Applicant in this Background Check Affidavit is true and accurate to the best of my knowledge. I understand that any false statements or omissions may result in disqualification from employment.

[Date]

Sworn to and subscribed before me this [Date] day of [Month], [Year].

[Your Company Seal]