• USA INVESTIGATIONS, LLC

    6750 N ANDREWS AVE, SUITE 200

    FT. LAUDERDALE, FL 33309

  • This is USA Investigations’ client questionnaire for individuals who are seeking background check only. You will need to complete two forms. Please note that some of the questions are repetitive. Please answer all questions. If any of the questions do not pertain to you, enter N/A in that section. Once you complete the form you will receive a copy of your answers for your review. You will also have an opportunity to preview your responses before submitting your form. To preview the form, click on the preview tab at the end of the form. To return to the form, click on the “Return to Form tab at the top of the first page.

  • Date*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Date of Birth*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.

  • PLEASE CIRCLE ONE OF EACH:

  • Gender*
  • Race*
  • Eye Color*
  • Hair Color*

  • USA INVESTIGATIONS, LLC

    6750 N ANDREWS AVE, SUITE 200

    FT. LAUDERDALE, FL 33309

    DISCLOSURE/AUTHORIZATION FOR RELEASE OF INFORMATION FOR EMPLOYMENT PURPOSES-Bacgroun Screening Disclosure

    DISCLOSURE

    By this document the facility discloses to you that a consumer report or investigative Consumer Report may be obtained for employment purposes as part of our employment screening process and at any time during your employment with our company. This shall authorize the procurement of a consumer report by the facility as part of the employment background screening process. If hired, this authorization shall remain HCL on file and shall serve as an ongoing authorization for the facility to procure consumer report at any time during my employment. The background check company USA Investigations will prepare the report for the company. USA Investigations is located at 6750 North Andrews Ave, Ft. Lauderdale, Florida 33309 and can be reached by phone at 954-778-3932 or at their internet website address http://www.usainvestigations.us.

    Authorization

    I also authorize the procurement of a consumer report for an investigative consumer report and understand that it may contain information about my criminal history, driver's history, mode of living, character and personal reputation. I hear my authorized the release of all information to USA training academy and investigative services. I understand that I have the right to obtain additional disclosure as to the nature and scope of the investigation upon written requests with a within a reasonable period of time and to obtain a copy of the report upon request. This authorization, an original or copy former, shall be valid for this and any future report or update that may be requested.

    This authorization and concent shall be valid in origina, fax, or copy form. The following information is requeied by law enforcemment agencies and other entities for identification purposes when checking records. I is confidential and will be used for any other purpose. 

    ** Asummary of Your Rights under the Fair Credit Reporting Act is also being provided to your with this form. 

  • Date of Birth
     / /
    2 digit month, 2 digit day, 4 digit year

  • Current and prior address: Please provideadress for the last seven (7) years. If you do not have any prior address enter N/A. If more space is needed enter more address at the end of the page. 

  • Date
     / /
    2 digit month, 2 digit day, 4 digit year
  •  
  • Should be Empty: