To Whom It May Concern
Please print
I
last name First name Middle name
I hereby authorize KPMG or their representatives to verify information presented on my
employment application/resume and to procure an investigative report or consumer report for
that purpose.
I hereby grant authority for the bearer of this letter to access or be provided with full details.
• Of my previous employment record held by any company or business for whom I
previously worked. This information should include the dates of employment; the nature
of the position held, [details of my salary upon departure] and an appraisal of my
performance, capabilities, and character. In addition, please provide any other pertinent
information requested by the individual presenting this authority. I hereby release from
liability all persons or entities requesting or supplying such information.
• I understand and authorize this research to include, but is not limited to, retrieving
criminal records, educational records, employment history, credit/financial reports, motor
vehicle/driving records, civil records, reference checks, sex offender status information,
professional licenses verifications, and Id verifications including those records maintained
by both public and private organizations law enforcement agencies, educational
institutions (including public and private schools/universities), foreign and domestic
corporations, employers, information service bureaus, record/data repositories, courts and
police stations, within or outside the European Union and other countries to release such
information. I agree that this Authorization form in original, facsimile, photocopy, or
electronic (including electronically signed) formats, will be valid for KPMG or any agent of
KPMG to conduct any research, order any reports or produce any reports that may be
requested by, or on behalf of the Company.
• Of my qualification/degree (copy of my certificates attached)
• Information in respect to my character from the records maintained by local authorities
Signature Date: DD / MM /
YYYY