Consent and Authorization for Background / Due Diligence Check Please read carefully before submitting your information Date *Applicant / Subject Name *Other Names Used (if any)Date of Birth *MonthSelect month123456789101112DaySelect day12345678910111213141516171819202122232425262728293031YearSelect Year212621252124212321222121212021192118211721162115211421132112211121102109210821072106210521042103210221012100209920982097209620952094209320922091209020892088208720862085208420832082208120802079207820772076207520742073207220712070206920682067206620652064206320622061206020592058205720562055205420532052205120502049204820472046204520442043204220412040203920382037203620352034203320322031203020292028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926Street Address *SSN# *Upload or attach-A copy of a government-issued photo ID is required to verify identity. *Drag and Drop (or) Choose Files1. AuthorizationI, the undersigned, hereby authorize (“K.N.O.W Consulting Group,LLC”) and its representatives, agents, or third-party service providers to conduct a background and/or due diligence investigation for lawful purposes.2. Scope of Information *I understand that this investigation may include, but is not limited to, the following information: Identity verification and personal history Employment history and references Education and professional credentials Criminal records (where permitted by law) Credit history (if applicable and permitted) Civil litigation history Business affiliations and directorships Regulatory or compliance records 4. Use of Information *Investment Opportunity /Venture Capital Funding/ Business RelationshipEmploymentContracting / Vendor ApprovalTenancyOther:I understand that the information obtained will be used solely for evaluating my suitability for:5. Fee for Background / Due Diligence Check *I acknowledge and agree that a non-refundable fee of $500.00 (Five Hundred Dollars) is required to conduct the background and due diligence check. Payment must be made prior to the initiation of the investigation unless otherwise agreed in writing. I understand that the fee covers administrative costs, third-party verification services, and processing, and is not contingent upon the outcome of the review.6. Confidentiality *K.N.O.W. Consulting Group, LLC agrees to handle all obtained information in accordance with applicable privacy and data protection laws and to use it only for the stated purpose.7. Duration of Consent *One-time checkOngoing monitoring during relationshipUntil revoked in writingThis authorization shall remain valid for:8. Rights and Acknowledgment *I acknowledge that: I may withdraw this consent at any time in writing, subject to legal or contractual restrictions. I certify that the information I have provided is true and complete to the best of my knowledge. SubmitPlease do not fill in this field.
