Client Reference Number / Case Name:
Individual Requesting Search:
Requestors E-mail Address:
Authorization Code (Encrypted):
Additional Information: Select Reports Needed: -Bankruptcy Report -Criminal Report -Civil Report -Credit Report (Requires Signed Release faxed to PDI) -Federal Criminal History -Federal Civil History -Motor Vehicle Report (Driving Record) -Professional License Verification -State-Wide Criminal History (Where available) -Corporate Credit Report Note: Providing your Social Security Number of other sensitive data remains the liability of the client.