Important – to be completed by employer or recruiter
1.Photocopy 2 pieces of identification, 1 piece must be government issued with candidate’s picture and signature.
2. Scan these pages and Email to INFO@REFERENCESANDMORESERVICES.COM OR FAX TO 1-866-665-4759
3. When photocopying ID, ensure it is clear and can be read.
Identification Verification of Employee
If “Yes” please provide details below. Do not declare the following: Absolute discharges or Conditional Discharges, pursuant to the Criminal Code,
section 730. Any charges for which you have received a Pardon, pursuant to the Criminal Records Act. Any offences while you were a “young person” (12 years old but less
than 18 years old), pursuant to the Youth Criminal Justice Act. Any charges for which you were not convicted, for example, charges that were withdrawn, dismissed, etc. Any
provincial or municipal offences. Any charges dealt with outside of Canada.
Candidate’s Signature Authorizing Name Based Criminal Check
Date Format: MM slash DD slash YYYY