Please Download And Complete The Following Forms URS Job-Application × The contract Download Please enable JavaScript in your browser to complete this form.File Upload Click or drag a file to this area to upload. Submit Background Authorization × CONFIDENTIAL Background Check Authorization Please enable JavaScript in your browser to complete this form.Print Name: *Former Name(s) and Dates Used: *Current Address Since: *Previous Address From:Previous Address From: Social Security Number: *DOB *Telephone Number: *Checkboxes *The information contained in this application is correct to the best of my knowledge. I hereby authorize Universal Rehabilitation Services and its designated agents and representatives to conduct a comprehensive review of my background including a consumer report and/or an inves-tigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit reports, current and previous residenc-es; employment history, education background, character references; drug testing, civil and criminal his-tory records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, OIG Exclusion Check, DADS Employability Check and any other public records. I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or written, pertaining to me, to Universal Rehabilitation Services or its agents. I fur-ther authorize the complete release of any records or data pertaining to me which the individual, com-pany, firm, corporation, or public agency may have, to include information or data received from other sources. Universal Rehabilitation Services and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicant’s personal information, including, but not limited to, addresses, social security numbers, and dates of birth. Date *Signature *Clear SignatureSubmit URS FW9 Download Please enable JavaScript in your browser to complete this form.File Upload Click or drag a file to this area to upload. Submit