Print and complete this form and mail or fax to:
Crimescreen
Post Office Box 2513
Scottsdale, Arizona 85251
Fax to (602) 485-5267

Screening Services Terms and Conditions

 

Crimescreen Screening Services User Agreement
COMPANY INFORMATION

Company Legal Name:___________________________________________________________________

Legal Address: _______________________________________________________________________
 CityStateZip CodeCounty

Contact/Title: _______________________________________________________________________
 FirstLastTitle

Phone: __________________ Fax: ________________ E-mail: _______________________________

Executive Contact/Title: _______________________________________________________________
 FirstLastTitle

Phone: __________________ Fax: ________________ E-mail: _______________________________

Billing Address (if different from Legal):

__________________________________________________________________________________
 StreetCityStateZip CodeCounty

Billing Contact: ______________________________________________________________________
FirstLastTitle

Phone: __________________ Fax: ________________ E-mail: _______________________________

 
Services/Products/Programs

To be completed by Crimescreen
Services/Products/Programs
Pricing
Pre-Employment Package
$
Tenant Package  
Other  
Totals
 

To be completed by applicant

Number of Employees:______Type of Business: __________________________ # of Years in Business:_____

Account Type: (Please check all that apply)
FCRA Regulated Account (Must provide permissible purpose) Non FCRA Regulated Account

Legitimate business need in connection with a transaction initiated by the consumer.
For Employment Purposes.
For the underwriting of insurance as a result of an application from the consumer.
For the extension of credit as a result of an application from the consumer of the review or collection of a consumer account.
For use by a potential investor of servicer, or the current insurer, in validation of, or assessment of the credit repayment risk associated with an existing obligation.
BILLING INFORMATION

Billing Information: (Please check appropriate box)

   Bill any charges to credit card on an ongoing basis
   Direct debit
   Net 30 days billing option

If paying by credit card, please complete the following : (VISA, Mastercard and American Express)
 

____________________________________________________________________________________
 Card Type Card Number Expiration DateCardholder Name

If paying by direct debit, please complete the following and attach a copy of your check to this sales order:

____________________________________________________________________________________
 ABA(Transit #) Account Number Bank Name

____________________________________________________________________________________
 Bank Address Phone Number Contact

THE SERVICES COVERED BY THIS AGREEMENT ARE PROVIDED IN ACCORDANCE WITH THE TERMS AND CONDITIONS ABOVE AS WELL AS THE TERMS AND CONDITIONS ON THE REVERSE SIDE OF THIS AGREEMENT.
Crimescreen AuthorizationDate  
Client AuthorizationDate Effective Date
FOR INTERNAL USE ONLY
Affiliate (Account Name):____________________  Phone #: ________

 

After reading through the terms and conditions, return to the User Agreement

 

Terms for User Agreement

This agreement by and between Crimescreen and the company named on the reverse of this page (User) and/or its designated agent(s) shall consist of the following understandings and conditions.

User Agrees to

1. Read and maintain on file the attached copies of the Fair Credit Reporting Act (FCRA) and Chapter nine of the Technical Assistance Manual (Title I) for the Americans with Disabilities Act (ADA).

2. Accept responsibility for using information provided by Crimescreen (Consumer Reports) in accordance with the Fair Credit Reporting Act (FCRA), Public Law 91-508 and the Americans with Disabilities Act (ADA 1990).

3. Be aware that some states have stricter "Human Rights" and ADA based statutes in force for employers. Compliance with these laws is the responsibility of the User.

4. Obtain a proper release and authorization from each job applicant.

5. Recognize that information is obtained and managed by fallible sources, and that for the fee charged, Crimescreen cannot guarantee or insure the accuracy or the depth of information provided.

6. Assume responsibility for the final verification of the applicant's identity.

7. The fact that Crimescreen employees are not allowed to render any opinions regarding information contained in a consumer report. Hiring decisions or any actions must be based on User policies and procedures.

8. Give the applicant Crimescreen's 800# and address if information provided in a consumer report is responsible for suspension or termination of the application process.

9. Use Address and Credit reports for employment purposes only.

10. Pay for services based on a statement system similar to ones used by telephone companies. Terms are NET 30 days. Accounts in arrears will assume a finance charge of 2% per month. If account goes to collection, user agrees to pay all expenses including legal fees.

11. Be aware that if an account remains inactive for twelve consecutive months, it will be closed.

Crimescreen Agrees to

1. Comply with all applicable laws in the preparation and transmission of reports as defined in 15 USC-1681 et seq, regulated by the Federal Trade Commission.

2. Follow reasonable quality assurance procedures to assure maximum possible accuracy of information.

3. Re-verify at no cost when a User makes the request by telephone or the subject makes a request in writing. Crimescreen's response shall be made in writing and delivered in a timely manner.

4. Maintain consumer report information and transaction details for a minimum of two years. During an inquiry, the subject of the report has the right to learn the name of the User ordering information and has the right to be informed of the substance of the report ordered by the User when a written request is made to Crimescreen.

5. Provide consumer information in compliance with the Fair Credit Reporting Act.

6. Maintain confidentiality of its data acquisition and verification methodology and Crimescreen may, at its sole discretion, terminate service to any user.

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