1600-04, BACKGROUND INVESTIGATION QUESTIONNAIRE. 1000 - Administration and Management - fdic-2026

1. Click ‘Get Form’ to open the 1600-04 questionnaire in the editor.
2. Begin with SECTION I - GENERAL INFORMATION. Fill in your full name, Social Security Number, sex, date of birth, and place of birth. If you are not a U.S. citizen, provide your country of citizenship.
3. Continue by listing any other names you have used along with the dates they were used. Then, provide your residential address for the past ten years.
4. In this section, also include your employer's name and address, office telephone number, title/position, and years with the employer.
5. Move to SECTION II – DISCLOSURE. Answer each question by checking 'Yes' or 'No.' If you answer 'Yes' to any question, attach a detailed explanation on a separate sheet.
6. Proceed to SECTION III – ELIGIBILITY CERTIFICATION. Read each statement carefully and ensure that all are true before signing.
7. Finally, complete SECTION IV – AUTHORIZATION TO RELEASE INFORMATION by signing and dating the form in ink.

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