Request for renewal of individual background screening application 2025

1. Click ‘Get Form’ to open the Request for renewal of individual background screening application in our editor.
2. Begin by filling out the 'Covered Entity/Employer Information' section. Enter the name of the covered entity as listed on the license, followed by the administrator or designee's printed name, signature, and date.
3. Next, complete the 'Applicant Information' section. Fill in your sex, last name, first name, middle initial (MI), date of birth, social security number, and driver's license number.
4. Indicate your prior clearance date in the designated field. Ensure all information is accurate to avoid processing delays.
5. If necessary, include additional pages by selecting 'Add Page' within our platform to provide any extra information required.
6. Finally, review all entries for accuracy before submitting your completed form through our editor.

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