PMM Sample Background Check Authorization Form.doc. 00312588.DOC1 - southside 2026

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  1. Click ‘Get Form’ to open the PMM Sample Background Check Authorization Form in the editor.
  2. Begin by entering your full name in the 'Print Name' section, ensuring you include your first, middle, and last names.
  3. In the 'Former Name(s) and Dates Used' field, provide any previous names along with the dates they were used.
  4. Fill out your current address in the designated fields, including street, city, state/zip code, and how long you've lived there.
  5. Complete the 'Previous Address From' section by listing any past addresses along with their respective durations.
  6. Enter your Social Security Number, Date of Birth (DOB), telephone number, and driver's license number/state as required.
  7. Review the authorization statement carefully before signing and dating the form at the bottom.
  8. If you are a resident of California, Minnesota, or Oklahoma and wish to receive a copy of your background check report, check the appropriate box.

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