Você está na página 1de 1


1. Print down this form.
2. Print your full name and social security number at the top of the form.
3. Sign and date the bottom of the form.
4. Fax this form (within 24 hours of submitting your online application) to: 312-453-5947

PRINT Your Name: Last, First, Middle Social Security Number

__ __


I hereby authorize Bank of America and its affiliates to solicit and receive all information relating to my prior
employment from my past and current employers and to solicit and receive all information relating to my education
from the schools I attended. I also authorize Bank of America to use any information it has or obtains that relates to
me and to verify the accuracy of the information I provided on this Applicant Screening Investigation Authorization
and Release Form.

In addition, I hereby authorize my prior employers to provide information about me to Bank of America for
employment purposes and I release them and Bank of America and all of their respective affiliated entities, officers,
directors, agents, and employees from any and all claims and liabilities of any nature (including costs and attorneys’
fees) arising from or related to such inquiry or investigation or the supplying of information for such inquiry or
investigation or the content of any information used, obtained or supplied.

I further agree that a copy of this Authorization and Release has the full force and effect as the original.

Signature: Date: / /