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How to fill consent and indemnity form

How to fill consent and indemnity form 2026

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The document is a Consent and Indemnity Form for a company, requiring personal and contact information from the applicant. It outlines the authorization for background checks, including criminal records, credit profiles, and educational qualifications, to be conducted by LexisNexis Risk Management. The applicant indemnifies the company and its verification agents against any liability arising from the provision of this information. The form must be completed and submitted to LexisNexis.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Company Information. Fill in the Company Name, Agent Name, E-Mail, Phone, and Fax fields as required.
Next, complete the Individual Information section. Provide your Surname, First Name/s, ID Number or other identification details, Date of Birth (mandatory if ID No. is not provided), and Physical Address.
In the Checks/Request section, list any Criminal Records or Qualifications you wish to declare. Ensure that all relevant institutions and qualifications are accurately noted.
Review the Indemnity clause carefully. By signing this section, you authorize The Company and its verification agents to process your personal information for employment purposes.
Finally, sign and date the form at the designated areas. If applicable, ensure a Parent Signature is included for minors.

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2018	4.8 Satisfied (76 Votes)
2008	4 Satisfied (22 Votes)

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