To Whom It May Concern:
I herby authorize and request any present or former employer (except for those indicated on my application form), school, police department, financial institution or other persons having knowledge about me, to furnish bearer with any and all information, including criminal, driving and credit history, in their possession regarding me in connection with the application for employment I have submitted to Heartland Estate Staffing. I am willing that a photocopy of this authorization form be accepted as the original. I specifically waive any written notice from any present or former employer who may provide information based upon this authorized request. I understand this authorization is to be part of the written employment application that I sign.

I recognize that this form I am signing is a stand-alone notification that a background report may be requested and used for the purpose of evaluating me for employment opportunities presented to me by Heartland Estate Staffing.

Information shared on this page will not be shared nor stored on line and will not be shared with anyone with the exception of potential employers and only if they have scheduled an in person interview with you.