Screening Form | Aha Carrier LLC

Please Complete The National Background Screening Consent Form

Applicant Full Name *

Social Security Number *

Date Of Birth *

Provide Full Address*

I authorize and give consent for the above named organization to obtain information regarding myself. This includes the following: • Local Criminal background records/information • National Criminal background records/information • All 50 State Sex Offender Registries • Full Address Trace • Social Security Verification*

I Consent

Motor Vehicle Check*

I the undersigned, authorize this information to be obtained either in writing or via telephone in connection with my application. Any person, firm or organization providing information or records in accordance with this authorization is released from any and all claims of liability for compliance. Such information will be held in confidence in accordance with the organization’s guidelines. By signing this document, I am providing the above named organization my consent for an initial background check as well as any subsequent background checks deemed necessary throughout the length of my employment with this organization. *

Date *

Carrier and Load Management

Reliable transport solutions for your business needs.

contact us

+1 (859) 999-2141

Dispatch@ahacarrierllc.com

6044 Taylor DR, Apt 80

Burlington, KY 41005