M&K Record Researchers, Inc.

Please complete the information below and we will begin processing your employment screening request right away.  You may also download our release form and fax it to our office if you prefer.

Records Check Request Form

1. Your Name(required)
2. Company Address(required)
3. Email(valid email required)
4. Phone(required)
5. Applicant Name(required)
6. SSN(required)
7. DOB(required)
8. Applicant Address(required)
9. Applicant City(required)
10. Applicant State(required)
11. Applicant ZIP(required)
12. DL(required)
13. Searches Requested (check all that apply)
14. Social Security Verification
    Nationwide Criminal Records Check
    State Criminal Records Check
    Security Watch List
    Professional License Verification
    Driving Records Check
    Employment History Verification
    Credit Check
    Educational Verification
    National Sex Offender Check
    Military Service Verification
    
15. State / CountyIndicate the states or counties you wish to be searched (if different from info provided above).
16. Legal Disclaimer (please review)The information provided is true to the best of my knowledge and belief. I understand that any misrepresentation or false statement made by me in connection with the application or any related documents which is deemed material by The Company shall result in The Company not employing me or, if employed, terminating my employment. I understand and agree that all information furnished in my application and all attachments may be verified by The Company or its authorized representative. I hereby authorize all individuals and organizations named or referred to in my application and any law enforcement organization to give The Company all information relative to such verification and hereby release such individual, organizations, and the Company from any and all liability for any claim or damage resulting there from. I hereby acknowledge thst I have been informed by The Company that The Company may seek to obtain a consumer credit report and,/or an investigative report that will include personal information regarding me, including but not limited to , educational history, work references, driving record, drug testing and criminal convictions or arrest records if allowed, in order to assist The Company in making certain employment decisions. I further acknowledge notification by The Company that reports may be provided to The Company by other firms subcontracted for that purpose. I, my heirs, assigns and legal representatives, hereby release and fully discharge The COMPANY its parent and affiliated companies and the respective officers, directors, shareholders, employees, agents of each, including subcontractors, from any and all claims, monetary or otherwise, that I may have against The Company, its parents, its affiliates or subcontractors, arising out of the making, or use of, cither a consumer report and/or an investigative report, including any errors or omissions contained or omitted from such report or investigations. The Company agrees to inform you if a employment decision has been influenced by information contained in a consumer report made at our request by M&K Record Researchers. You may obtain a free copy of the report within sixty days by calling M&K toll-free at 866-393-0550 (Toll Free Fax 877-893-0832). M&K will make available to you “ A Summary of Your Rights Under The Fair Credit Reporting Act.
17. I have read and understand the legal disclaimer.
18. Questions? Call 866-393-0550
19. CommentsPlease enter any general comments here.

 

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