61748933;1
BACKGROUND CHECK CONSENT FORM
Pursuant to California Assembly Bill 506 of 2021 (AB-506) (formally referred to as California
Business and Professions Code Section 18975), [Name of Council] Council (Council) requires all
Employees, Administrators and Regular Volunteers to complete a background check. This Consent
Form outlines how the Boy Scouts of America (BSA) and our Council will request, receive, use
and share an individual’s criminal offender record information (CORI) received from the
background check. Please review, sign and return this form to the Custodian of Records, [insert
CORs name here] at [Email Address] .
I, ____________________, do hereby acknowledge and consent to all of the following statements:
Print Name
o I understand that in order to serve as an Employee, Administrator or Regular Volunteer for
this Council, I must comply with the background check requirements set forth in AB-506
and by this Council.
o I understand that by submitting my Request for Live Scan Service form and providing
my fingerprints, I am authorizing this Council to request my CORI from state and federal
agencies (including the FBI) for the sole purpose of determining whether I am allowed to
serve as an Employee, Administrator or Regular Volunteer for this Council.
o I understand that the Custodian of Records for this Council will receive my CORI through
secure means from the Department of Justice.
o I authorize the Custodian of Records for this Council to review my CORI in order to
determine whether I can serve as an Employee, Administrator or Regular Volunteer for
this Council.
o I authorize the Custodian of Records to share my CORI with a designated employee of
BSA if the Custodian of Records needs further guidance regarding my ability to serve as
an Employee, Administrator or Regular Volunteer for this Council.
o I understand that the Custodian of Records may share whether I am authorized to
participate in Scouting activities with another council if this Council receives a request
regarding my ability to serve as an Employee, Administrator or Regular Volunteer for
another council.
o I understand that I may challenge the accuracy or completeness of my FBI criminal history
record, that I will be afforded a reasonable amount of time to do so (or decline to do so)
before being denied a benefit based on any information contained in my criminal history
record, and that further guidance can be found at: https://www.fbi.gov/about-
us/cjis/background-checks. I further understand that the procedures for obtaining a change,
correction or update of an individual’s criminal history record are set forth at Title 28, Code
of Federal Regulations, Section 16.34.
