Declaration and consent relating to legal background

DECLARATION AND CONSENT RELATING TO JUDICIAL BACKGROUND FOR STAFF RENTER AGENCY

IDENTIFICATION

Email *

Family name *(if you have more than one surname, please enter your names in the usual order)

First name (s) : *Please enter all your first names if you have more than one.

Date of birth *

Gender : *MaleFemaleOther

Phone number *

No, Rue *

Appartement, suite, etc *

Ville *

Province *

Code postal *

Other addresses if different from the current address in the past 5 yearsIf differents !

Indicate the supporting document you mentioned below *Driving licenceSocial insurance numberPassport numberHealth card number

Supporting document number *

Download or take a picture of the supporting document *

No file chosen

As part of the contracts offered on its platform, Staff Renter offers contracts that can take place with vulnerable people.

What do we mean by “vulnerable people”?

According to the definition of the Criminal Records Act, "vulnerable persons" are a category of persons who, because of their age, a handicap or other circumstances, temporary or permanent, find themselves in a situation of dependence vis-à-vis - vis-à-vis other people or being in a more risky situation than the general population, to be attacked by people in a position of authority or trust in relation to them. Children, as defined in the Criminal Records Act, are under the age of 18.

This background check is the responsibility of the company due to its due diligence.

What do we mean by "due diligence"?

Due diligence is a legal principle that determines our company's obligation to take reasonable measures to ensure the safe delivery of care to our clients and to protect them according to the relevant standards in force.

List of Inconsistent Offenses and Misconducts

For your information, here is the list of offenses incompatible with any establishment offering accommodation to a vulnerable clientele.

SEX: Any conduct or offense of a sexual nature such as sexual assault, indecent acts, solicitation or incitement to prostitution, etc.
VIOLENCE: Any behavior or criminal offense for which any form of violence was used such as homicide, robbery, assault, kidnapping, forcible confinement, threats, intimidation, harassment, etc. .
THEFT - FRAUD: Any conduct or offense the very nature of which amounts to theft or fraud such as burglary, larceny, taking a motor vehicle without consent, fraud, corruption, assumption of person, etc.
DRIVING: Any conduct or criminal offense relating to the operation of road vehicles such as impaired driving, hit and run, dangerous driving, etc.
DRUG - NARCOTICS: Any conduct or offense relating to narcotics, food and drugs such as possession, trafficking, importation culture, etc.
OTHER: Any behavior or offense that raises fears for the safety of vulnerable people such as arson, gangsterism, mischief, etc.

DECLARATIONS OF GUILTY *I have not been found guilty of a criminal or penal offense incompatible with any establishment offering accommodation to a vulnerable clientele, in Canada or abroad or, if I have been found guilty of such an offence, I have obtained forgiveness.I have been convicted, in Canada or abroad, of the following criminal or penal offense or offenses. (Please enter them in the table below)

Date and convictions

CHARGES STILL PENDING *I am not the subject of a charge still pending for a criminal or penal offense incompatible with any establishment offering accommodation to a vulnerable clientele, in Canada or abroad.I am the subject of one or more charges still pending, in Canada or abroad, for the following criminal or penal offense (s) (Please enter them in the table below)

Date and pending charges

JUDICIAL ORDERS *I am not the subject of any outstanding court order against me, in Canada or abroad.I am the subject of one or more court orders which remain against me, in Canada or abroad, namely: (Please enter them in the table below)

Date and court orders

electronic signature *I certify that the information provided in this declaration is accurate and complete, and that I undertake to inform the Staff Renter Agency of any misconduct manifested or offense committed as a result of this declaration. I also certify that accepting the terms electronically has the same status and scope as a manual signature on my part.It is a serious offense to make a false statement

DECLARATION ON BACKGROUND CHECKS

CONSENT OF LEGAL BACKGROUND

For your information, here is the list of offenses incompatible with the exploitation of a resource offering accommodation to vulnerable customers.

FILTERING CRITERIA:

Scope and list of incompatible offenses

SEX : Any behavior or any offense of a sexual nature such as sexual assault, indecent acts, solicitation or incitement to prostitution, etc.
VIOLENCE : Any behavior or any criminal offense for which any form of violence has been used such as homicide, robbery, assault, kidnapping, forcible confinement, threats, intimidation, harassment, etc.
THEFT - FRAUD : Any behavior or any offense the very nature of which can be likened to theft or fraud such as burglary, simple theft, taking a motor vehicle without consent, fraud, corruption, assumption no one, etc.
AUTOMOTIVE DRIVING : Any behavior or any criminal offense relating to the driving of road vehicles such as impaired driving, hit and run, dangerous driving, etc.
DRUGS - NARCOTICS : Any behavior or any offense relating to narcotic drugs, food and drugs such as possession, trafficking, importation culture, etc.
OTHER : Any behavior or any offense that fears for the safety of vulnerable people such as arson, gangsterism, mischief, etc.

I, the undersigned, consent to Staff Staffer undertaking and requesting my personal information and background, that is, any conviction or indictment for a criminal or penal offense.

Have you ever been checked for your criminal record?YesNoIf yes, please enter the date in the box below.

Verification date :If the answer is yes

ADDITIONAL VERIFICATION CONSENT

In addition to this sworn statement, I, the undersigned, consent to Staff Renter using my personal information to officially verify my criminal background, i.e., any convictions or indictments for a criminal or penal offense in Canada, but also internationally, as well as any misconduct that could reasonably cause fear for the physical or moral safety of vulnerable people with whom I will be called upon to work.

CONSENT OF LEGAL BACKGROUND

For your information, here is the list of offenses incompatible with the exploitation of a resource offering accommodation to vulnerable customers.

FILTERING CRITERIA:

Scope and list of incompatible offenses

SEX : Any behavior or any offense of a sexual nature such as sexual assault, indecent acts, solicitation or incitement to prostitution, etc.
VIOLENCE : Any behavior or any criminal offense for which any form of violence has been used such as homicide, robbery, assault, kidnapping, forcible confinement, threats, intimidation, harassment, etc.
THEFT - FRAUD : Any behavior or any offense the very nature of which can be likened to theft or fraud such as burglary, simple theft, taking a motor vehicle without consent, fraud, corruption, assumption no one, etc.
AUTOMOTIVE DRIVING : Any behavior or any criminal offense relating to the driving of road vehicles such as impaired driving, hit and run, dangerous driving, etc.
DRUGS - NARCOTICS : Any behavior or any offense relating to narcotic drugs, food and drugs such as possession, trafficking, importation culture, etc.
OTHER : Any behavior or any offense that fears for the safety of vulnerable people such as arson, gangsterism, mischief, etc.

I, the undersigned, consent to Staff Staffer undertaking and requesting my personal information and background, that is, any conviction or indictment for a criminal or penal offense.

electronic signature *I acknowledge by accepting the terms electronically to the same status as a manual signature.

Signature *

DECLARATION AND CONSENT RELATING TO LEGAL BACKGROUND