VERACITY SYSTEMS LLC Application Form

  • VERACITY SYSTEMS LLC – Application Form

    Complete this form to apply to work at Veracity Systems LLC

  • EMPLOYEE INFORMATION

  • Date of Birth*
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  • Format: (000) 000-0000.

  • POSITION CONFIRMATION

  • Employment Type*
  • Desired Start Date
     - -
  • Days Available to Work (Select all that apply)*
  • Times of Day Available to Work (Select all that apply)*
  • Do you have reliable transportation?*
  • Do you have an active CPR/First Aid Certification?*
  • Do you have a current TB test?*
  • Do you have a current Physical Exam?*

  • WORK ELIGIBILITY

  • Are you authorized to work in the U.S.?*
  • Will you require sponsorship now or in the future to work in the U.S.?*

  • BACKGROUND DISCLOSURE

  • Have you ever been convicted of a crime?*
  • Do you authorize VERACITY SYSTEMS LLC to conduct a background check on you as part of the employment process?*

  • ACKNOWLEDGMENT AND AUTHORIZATION FOR BACKGROUND CHECK
    I acknowledge receipt of the FCRA required documents DISCLOSURE REGARDING BACKGROUND INVESTIGATION and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT which are both available at

    https://help.checkr.com/s/article/360036928693-What-is-the-Fair-Credit-Reporting-Act-FCRA and  Summary of Rights 2023.pdf for SafeHiring and I certify that I have read and understand both of those documents. I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” at any time after receipt of this authorization and, if I am hired, throughout my employment. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, workers compensation bureau, testing laboratory or insurance company to furnish any and all background information requested by Checkr and SafeHiring 1 Montgomery St. Ste 2400 San Francisco CA 91203, 844-824-3257, or another outside organization acting on behalf of Employer, and/or Employer itself. I understand that these files may contain negative information about my background, mode of living, character and personal reputation; therefore I agree to defend and hold harmless Checkr/SafeHiring and any agent acting on its behalf, from any and all liability arising through the investigation of my background. If applicable, I hereby authorize the release of my confidential report to any Third Party directly involved in the hiring or placement process and understand that any release to a third party will not occur until that party has completed a certification regarding the use and viewing of confidential information. I agree to release, hold harmless, and indemnify Checkr/Safe Hiring from any liability, claims, demands, causes of action, damages, or expenses resulting from: any release of information to the Third Party pursuant to this authorization; the unauthorized use of this information by the Third Party; and any actions taken by the Third Party pursuant to this authorization.

    I understand that my date of birth is used solely as an identifier to avoid possible misidentification while completing the background verification process. I agree that a facsimile (“fax”), electronic, or photographic copy of this Authorization shall be as valid as the original, and by signing this application, I authorize Veracity Systems and contractors to run my Background verification

     

     

                                              

     

                                                                                                                          

     

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  • Date*
     - -
  • Should be Empty: