Harmony Background Check

Consent Form

Applicant Information

Please provide your personal details as they appear on your official documents.

First Name

Middle Name (Optional)

Last Name

Other Names Used (e.g., Maiden)

Date of Birth

Social Security Number

Driver's License Number

State

Current Address

City

State

Zip Code

Phone Number

Email Address

Disclosure and Authorization

I understand that Harmony Inc. will use a third-party consumer reporting agency to obtain a consumer report and/or investigative consumer report ("Background Check Report") as part of the hiring process. This report may include information about my character, general reputation, personal characteristics, and mode of living. It may involve personal interviews with sources such as my neighbors, friends, or associates.

I hereby authorize Harmony Inc. to procure a Background Check Report on my background. This authorization is valid for the duration of my employment application process and, if hired, throughout my employment. I understand I have the right to make a request to the consumer reporting agency, upon proper identification, for a complete and accurate disclosure of the. nature and scope of the investigation.

I acknowledge receipt of the DISCLOSURE REGARDING BACKGROUND INVESTIGATION and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT. I certify that I have read and understand both of these documents.

Driver's License or Photo ID Upload

Upload a clear image

Please provide a front-facing image of your government-issued photo ID. Max file size: 5MB.

Signature

By signing below, you attest that all information provided is true and accurate.

Printed Name

Date

August 21st, 2025