Vendor Background Check ApplicationBackground Check - VendorsBackground Check Consent Form for VendorsFINGERPRINT AND CRIMINAL HISTORY BACKGROUND CHECK CERTIFICATION AND AUTHORIZATION FORM Name(Required) First Middle Last Maiden Name (if applicable)Current Mailing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email to be used for follow up and notifications(Required) Phone(Required)Date of Birth(Required) Driver's License Number(Required)StateProgram or Advisory Board Requesting Background Check(Required) Teen Center Recreation Municipal Alliance Borough of Morris Plains Clerk Other* (specify below)*If Other, please describe below, including requestor's email if possibleName of Borough program/event for which you will be a vendor(Required)Date(s) of the Borough program(Required)Social Security Number - Last 4 Digits(Required)Have you ever been fingerprinted(Required) Yes No Don' t RememberIf so, add dateHave you ever been arrested and/or convicted of a crime of offense?(Required) Yes and I will upload documents Yes and I will mail documents NoCrime of Offense Arrest / Conviction Drop files here or Select filesAccepted file types: pdf, doc, Max. file size: 256 MB.If yes, please attach detailed information of each such arrest or conviction. Alternative, you can mail documents to Morris Plains Police Department, c/o Background Check, 531 Speedwell Ave Morris Plains, NJ 07950. Uploading is the fastest way to have the background check complete.Have you ever been charged as a juvenile delinquent?(Required) Yes and I will upload documents Yes and I will mail documents NoJuvenile Delinquent Arrest/Conviction Documents Drop files here or Select filesAccepted file types: pdf, doc, Max. file size: 256 MB.If yes, please attach detailed information of each such arrest or conviction. Alternative, you can mail documents to Morris Plans Police Department, c/o Background Check, 531 Speedwell Ave Morris Plains, NJ 07950. Uploading is the fastest way to have the background check complete.Date(Required) Signature(Required)I certify that all of the information provided on this form is true to the best of my knowledge and belief. I hereby authorize and consent to this criminal history background check, which will be used to determine eligibility. Therefore, I authorize and consent for full release of records (either orally or in writing) to all authorized representatives of the Borough of Morris Plains. I authorize and consent to any future reports or updates to this criminal history background check that may be requested by the Borough of Morris Plains. In addition, I release and discharge the Borough and its employees and agents to the fullest extent permitted by law from any claims, damages, losses, liabilities, costs, expenses or any other charge arising from the retrieval and reporting of this information. I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment.
