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Due to security and privacy reasons ( please see IRSG principle ),
we are unable to provide services to individual customers.
The applicant has to be a business entity.

Please fill in this form (All information are required.)

 

Subscriber Application and Service Agreement

Company Name:
Type of Business:
Years in Business:
Year(s)
 
Specialization:
Federal Tax ID:
Physical Address
City:
State:
Zip Code:
Telephone:
Fax:
Contact Name (Last name, First name):
Email Address:
Industry Class:
 


Purpose of Use
(Please select one)
Conduct due diligence. Conduct vendor certification.
For use by any attorney, or law firm, to identify or locate an individual, business, and/or asset in carrying out its functions or legal representation.
Identify or locate an individual, business, and/or asset for claims investigations.
Identify or locate an individual, business, and/or asset for the purpose of collection activity.
Identify or locate an individual, business, and/or asset for asset identification.
Identify or locate an individual, business, and/or asset for risk management, fraud prevention/detection.
Identify or locate an individual, business, and/or asset in connection with any civil, criminal, administrative, or arbitral proceeding in any Federal, State, or local court or agency or before any regulatory body, including the service or process, investigation in anticipation of litigation, and the execution or enforcement of judgments and orders, or pursuant to an order of a Federal, State, or local court.
Agreement


I certify that I am authorized to execute this Subscriber Application and Service Agreement on behalf of the company listed above. Further, I certify on behalf of such company, that the above statements are true and correct and agree for the company to the terms and conditions set forth in the Subscriber Service Agreement stated above. My signature also authorizes the above listed references to release company's bank and trade credit information.

Accepted this day of ,
Signature box:
Checking this box signifies an electronic signature
Print Name:

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820 Sixteenth Street, 8th Fl. Denver, CO 80202
Phone: 1-800-200-0853 / 303-573-1130 Fax: 1-303-573-1779