I authorize Essential Services Inc/DetectFraud to conduct a criminal record database search to determine if there are any criminal record histories on me. I understand that Essential Services, Inc., is a reseller and does not maintain any records that may be detected.
I further understand that in the event that a criminal history is detected, Essential Services Inc will provide me with the contact information of the source of the information. I further understand that it will be my responsibility to dispute any inaccuracies with the source of the data retrieved.
I
authorize, without reservation, any and all criminal record database companies
accessed by Essential Services, Inc., to release any criminal record
information maintained on me. My signature, as signed, attests to my consent.
NAME
Last
_______________________ First
____________________ Middle _________________
ADD:
_________________________________________ City ______________ State ___
ZIP _____
Social Security # ________ - _____ - _________
Date of Birth _____/_____/________
____________________________________ ____/____/___
APPLICANT SIGNATURE DATE
Phone # _____________________________
This release must be faxed to727.538.0605. The turnaround time is
forty-eight hours.