To begin, print and complete the Service Agreement Form and the Billing Information Form provided below.
Fax the completed Forms to: 800-301-8049.
Your company will receive a copy of the completed Service Agreement Form (with your Account Number) by return fax.
You are then registered and can begin submitting orders.
 
Service Agreement for E-CriminalBackgroundCheck
This agreement is made by and between Subscriber and Washington Research Associates Inc (WRA), subject to the following terms and conditions:
 
1. WRA agrees to provide requested criminal records search pre-employment reports on individuals as furnished by Subscriber. WRA further agrees to take all reasonable steps to insure that Subscriber requests and information are kept confidential. Completed pre-employment check reports will be delivered to Subscriber via secure, password-protected web pages. Note that information obtained for use in E-CriminalBackgroundCheck is derived from databases and records maintained by various government agencies and private companies that are not under the control of WRA, and therefore responsibility for the accuracy of the information rests solely in the contributor. Said information is provided "as is."
 
2. SUBSCRIBER acknowledges compliance with the Fair Credit Reporting Act (FCRA) and state laws governing use of pre-employment screening information. A general summary of employer responsibilities under the FCRA and state laws is provided at the following URL:
http://clients.hypermart.net/FCRA_Compliance.html. Subscriber agrees to utilize E-CriminalBackgroundCheck only for employment purposes. Subscriber also agrees to provide WRA with a signed release ("Applicant Authorization Form", supplied by WRA) for each applicant for whom it is ordering an E-CriminalBackgroundCheck.
 
AGREED AND ACCEPTED:
 
___________________________________        _____________________________       _________
Subscriber (Company Name)                           (Authorized Representative)                  (Date)
 
______________________________________
 
Washington Research Associates Inc.               _____________________________        _________
                                                                    (Authorized Representative)                  (Date)
 
______________________________________
 
(Continued Below)
 
 
 
 
 
 
 
 
 
 
 
Please provide the following billing information about your company:
 

Billing Information Form
 
Company Legal Name:   ___________________________________
Legal Address:   ___________________________________
City:   ___________________________________
State:   ___________________________________
Zip:   ___________________________________
Company Contact/Title:   ___________________________________
Contact Email Address:   ___________________________________
Phone:   ___________________________________
Fax:   ___________________________________
 
Billing Address (if different from Legal):
 
Street:   ___________________________________
City:   ___________________________________
State & Zip:   ___________________________________
Billing Contact:   ___________________________________
Phone:   ___________________________________
 
PAYMENT OPTIONS:   ( ) Please charge credit card (MC/Visa/AmExp) for orders placed by my company. (A 5% discount applies)
     
    ( ) Please invoice. (Companies only. Net 30 days)
 
Cost of E-CriminalBackgroundCheck (STATE Criminal Records Search):
$90.00. There is no set-up fee. A 10% discount will be applied to orders totalling more than $1000 in a 30-day period.
 
If paying by credit card, please complete the following:
 
Credit card type:   ___________________________________
Card issued to:   ___________________________________
Billing address:   ___________________________________
City:   ___________________________________
State & Zip:   ___________________________________
Card number (xxxx-xxxx-xxxx-xxxx):   ___________________________________
Exp. date (xx/xx):   ___________________________________
 
Note: No charge will be made to your credit card until we have received your order or orders by fax, using our Applicant Authorization Form.
 
Comments/Special Instructions: ___________________________________
 
 
 
Please complete these forms (Service Agreement Form and Billing Information Form) and fax toll-free to 800-301-8049.

You will receive your Account Number and a link to the Applicant Authorization Form within one business day.
 
Privacy Statement
 
Your pre-employment check will be strictly confidential. Your Applicant's personal information will not be divulged to any third party. We respect your privacy and that of your Applicant. You, in turn, by ordering E-Background Check, acknowledge that your are complying with all state and Federal privacy laws and the FCRA in your use of this report.
 
Washington Research Associates Inc
1090 Vermont Ave., NW, Ste. 800
Washington DC 20005
(202) 408-7025
 
Email: info@washresearch.com
 
Note: Your company will receive a copy of the completed Service Agreement Form by return fax.