File a Dispute

If you have received a copy of an employment background investigative report and wish to dispute the accuracy or completeness of any information in the report, please complete the form, indicating which part(s) of the report you are contesting, the reasons you disagree with that part of the report, and any other information you deem relevant to your dispute.

First Name*:

Last Name*:

Address*:

Address 2:

City*:

State*:

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Phone*:

( ) - Second three digits Last four digits

Email*:

Birthday (mm/yyyy)*:

This information will be used for identification purposes to match you to a correct report. This information will be used for no other purpose.

Last 4 Digits of SSN*:

Reason for Dispute*:

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