Sheriff Background Check Consent Form

Sheriff Office Background Check Consent Form

I understand that Umatilla County will conduct a criminal history background check as part of the procedure for processing my application for employment.
I understand that Umatilla County will conduct an investigation that verifies my social security number and includes obtaining information regarding my past employment and criminal background. I understand the criminal history background check will include my counties of residence to search for criminal records.
I understand that the information contained in the criminal history background check will be available to those persons involved in making employment decisions or performing the background investigation, and that this information will be used for the purpose of making employment decisions.
Caution – Read Before Signing

Full name *

Other Last Name Used

Email address *

Date *

SSN *

Date Of Birth *

Drivers License *

State Of License *

Position Applied for *

Department *

Providing your social security number and date of birth are necessary to perform these investigations and will only be used with your consent for the purposes described above. Date of Birth information is obtained for identification purposes only and will not be used as a basis for making employment decisions.

Signature *

I hereby consent to the criminal history background check as described above and authorize Umatilla County to obtain reports concerning my background as stated above. I hereby release Umatilla County, its officers, agents and employees from any and all liability related to Umatilla County using my criminal background information to make employment decisions.