AmerUSA Employment Screening relocates its processing to West Florida.

AmerUSA now offers a 24 hr criminal background check

24 Hour Employment Background Check for Employers Nationwide.

Employer Registration Agreement - Required by the Fair Credit Reporting Act

This form must be printed and completed in its entirety and you must be a business entity to use our services. Please FAX this form to our processing department at (727) 467-0918. Registration documents without employee applications may take up to 24 hours to issue a USER ID.

Please note: Full reports can only be delivered by fax. Email reports are intended for clients who do not have immediate access to a fax machine. Email reports contain a profile summary and do not have collection dates, account numbers, etc. We recommend having your results delivered by fax unless you do not have a fax machine. Only one delivery method will be permitted per transaction.

ATTN: EMPLOYERS, YOU MUST FOLLOW THESE "4" STEPS TO REGISTER!

1. INCLUDE one of your ID's (i.e., driver license, passport or SSN card)
Please enlarge your ID if it is not legible.

2. INCLUDE proof of business (i.e., business license, tax bill or utility bill).

3. INCLUDE your employee's signed authorization or employment application. In case you do not have access to one, you may print our employee authorization free of charge. Note: We need the applicant's NAME, SSN, COMPLETE ADDRESS WITH ZIP CODE and SIGNATURE to run a background check.

4. FAX this completed registration along with ALL required documents to 727-467-0918.

*5. IF YOU HAVE ALREADY REGISTERED, DO NOT FAX THIS FORM AGAIN.

**Note: We strongly suggest receiving your results via fax. We can only send short summaries by email and only one delivery method is permitted per transaction.

REGISTRATION TURNAROUND: It may take up to 24 hours to process your registration and reports. For those expecting fax results, please make sure your machine is ready to receive.

Employer/Business Information

First Name: ______________________ Last Name:______________________

Company Name:_______________________________________ (if applicable)
  
Federal Tax ID or SSN (Required): ___________________________________

Phone: ________________________  Fax: ____________________________

**Email Address:___________________________________________________

Credit Card Billing Information (Visa or MasterCard Only)
We DO NOT accept AMEX or Discover

Account Number: ________________________________________________

Expiration Date: _________________ (mm/yy)

Name on Account: _______________________________________________

Billing Address:__________________________________________________

City: ________________________  State: ______  Zip Code: _____________

Service Agreement
I hereby agree to comply with the provisions of the Fair Credit Reporting Act (15 USC 16810) and to only request consumer credit report information for the sole purpose of screening my prospective employee for a position with my company. I shall hold in the strictest confidence all information received and will abide by the Access Security Requirements.  I also agree to obtain a executed application from each applicant stating they have agreed to allow me to conduct a pre-employment background investigation before I place an order for such file. Each executed application must be kept on file for two years. I further agree to grant AmerUSA the right to charge my credit card for each applicant inquiry I (or my authorized persons) submit.
 
  
Signature: __________________________________ Date:______________

Print Name: _________________________________

YOU ARE REQUIRED TO PROVIDE ALL OF THE ABOVE DOCUMENTS IN ORDER TO REGISTER FOR OUR SERVICES. REGISTRATIONS WILL NOT BE PROCESSED IF INCOMPLETE.