EMPLOYEE SCREENING ACCOUNT APPLICATION
I hereby authorize ABLE SCREENING SERVICES to provide customer screening services.I understand that ABLE SCREENING SERVICES has no control over the contents of the report issued by the authorized credit bureaus. PLEASE PRINT CLEARLY !!
WHERE DID YOU HEAR ABOUT ABLE SCREENING?_________________________
Company name : __________________________________ Years in
business
______
Type
of business ownership (indicate
one) Partnership _____
Sole Owner ____
Corporation ____
Responsible
party – Last name :____________________________First :_________________
Address :
______________________ City :
______________ State :______
ZIP:___________
Telephone
# : _______________________________ Fax # ____________________________
Banking
Reference (Name) :
___________________ email address:_____________________
Account
# : ____________________Soc. Security or Tax ID# ____________________________
The
applicant agrees to comply with all the provisions of Public Law 91-508 and the
Fair Credit Reporting Act (Public law 91-508 provides that any person who
knowingly and willfully obtains information on a consumer from a consumer
reporting agency under false pretenses shall be fined not more than $5,000 or
imprisoned not more than one year or both). Information supplied will be
requested only for applicants exclusive use and the applicant certifies that
inquires will be made only when the applicant intends to use the information for
permissible purposes of tenant screening only.
Applicant further agrees to hold information in strict confidence and
acknowledges they are the end user of this information. In the case the
disclosure of such information leads to any claims or litigation, applicant will
hold Able Screening harmless from any liability or damages resulting therefrom.
Able Screeningt shall not be liable in any manner whatsoever for any loss
or injury to applicant resulting from the obtaining or furnishing of such
information and shall not be deemed to have guaranteed the accuracy of such
information, such information being based, however upon reports obtained from
sources considered by Able Screening Services to be reliable.
It is
further agreed that if the applicant is delinquent in payment of charges, or is
guilty of violating the terms of this contract, Able Screening may, at its sole
discretion discontinue providing service to applicant. Applicant may only use
the report information obtained for the permissible use of business screening
only.
Authorized representatives
signature ___________________________________DATE___________
Title
__________________________
For
office use only
Verified
by :
___________________________________