The PEER Committee makes the background check form available online for the convenience of the filer. The form cannot be submitted electronically; it must be printed, signed, dated, and notarized. The form is in Adobe Acrobat PDF format. It is intended to be completed on a computer using either Adobe Acrobat Pro, the free Adobe Acrobat Reader​, or any other compatible PDF editor.
(Please note, this form is designed to support "in browser" filling of form fields. However, not all web browsers allow "in browser" filling of form fields.)
BEFORE completing the Background Check Form, please discuss with your appointing authority to determine if your appointment is subject to Senate advice and consent. Alternatively, you may review the Senate Confirmation Manual to determine if your appointment is subject to Senate advice and consent.
If your position is subject to the advice and consent of the Mississippi Senate, complete the Background Check Form (by typing your answers) and return it to the individual who made your appointment—i.e., DO NOT submit it directly to PEER staff. The completed paper form must be returned to the appointing authority (e.g., the Governor) rather than to PEER.
Click to download the following form: Background Check Form
If you have been appointed to the Veterans' Home Purchase Board or the Veterans' Affairs Board, please fill out this supplemental form and submit it with your background check form: Supplemental Form C: Appointees to the Veterans' Home Purchase Board or Veterans' Affairs Board