FROM: ________________________________________________________________

CONTACT PERSON: ____________________________________________________

RETURN FAX NO.: ______________________________________________________

Please conduct a pre-employment background evaluation on:

Name of Applicant: ______________________________________________________

(Please include the applicant’s signed Authorization and Release, Application for Employment and Resume)

__ Basic Background Package
__ General Background Package
__ Extensive Background Package

__ County Criminal Records Check Felony & Misd. (current residence only)
__ County Criminal Records Check past _____ residing counties
__ State Wide Criminal Records Check/Metro Area if available
__ Federal Court Criminal Records Check
__ Motor Vehicles Driving History past _____ residing states
__ Academic Verification
__ Professional Licensing Verification
__ Employment History Verification (Check here ___ to exclude current employer)
__ Personal References
__ Social Security Number(s) and Name Verification
__ Other Searches or Special Requests: _____________________________________
__ Please have FYI choose searches and verifications, not to exceed $_______ in cost.

All invoices payable within 15 days of search completion unless alternative arrangements are made in advance. Fee applies regardless of search outcomes.