e-VERIFILE.COM Short Customer Profile

Customer Profile
Fields in red are required

How did you hear about us?:

Business Name:

Business Address:

City/State/Zip:

Bus. Telephone:

Fax:

Year Founded:

Bus. TAX ID:

E-Mail:

Contact Name:

Title:

Telephone:

Type of Business:

Business License Number:

(Please fax a copy to 770-859-0717)

Bank Name:

Bank Telephone:

Contact Name at Bank:

Uses for e-VERIFILE.COM data --PLEASE CHECK ALL THAT APPLY--

Employment screening--any background check of an individual for hiring or retention purposes

Consumer lending and credit decision-making, including mortgage lending and credit application screening as well as decision-making regarding account limit increases/decreases or offering of more or less favorable account terms

Consumer insurance underwriting

Qualifying individuals for government licenses/benefits

Residential tenant screening

Collections of consumer accounts

Any use of data for the above purposes requires full compliance with the FCRA