PRINCIPAL OF THE COMPANY. If sole owner or partnership, please complete this section: I understand that the information provided below will be used to obtain a consumer report, and my creditworthiness may be considered when making a decision to grant membership Principal Name: Title or Position: Phone: Residential Street Address: City: State: Zip: AFFILIATED OR PARENT COMPANY: Do you have any branch offices located in the state of California? Yes No Affiliated or Parent Company Name: Contact Name: Title: Address: Phone: City: State: Zip: BUSINESS INFORMATION: Please tell us about your company. Type of Business: Do you need a Purchase Order? Yes No Do you have an Investigation License? Yes No If Yes, please provide a copy with this application. How will you access the Consumer Reports? Personal Computer Credit Terminal CPU-CPU Phone/Fax Do you already have a credit reporting software package? Yes No If yes, what is the name? Does your company qualify for sales tax exemptions? Yes No If Yes, please provide proof. PERMISSIBLE PURPOSE / APPROPRIATE USE: Application will not be processed unless this information is provided. Please describe the specific purpose for which consumer reports will be used. (What will you do with the information obtained?) NOTE: The response to this question must match the response placed on the Service Agreement. The following applies to companies ordering consumer reports and/or investigative consumer reports. I have read and understand the "FCRA Requirements" notice and "Access Security Requirements" and will take all reasonable measures to enforce them within my facility. I certify that I will use the consumer report/investigative consumer report information for no other purpose other than what is stated in the Permissible Purpose/Appropriate Use section on this application and for the type of business listed on this application. I will not resell the report to any third party. I understand that if my system is used improperly by company personnel, or if my access codes are made available to any unauthorized personnel due to carelessness on the part of any employee of my company, I may be held responsible for financial losses, fees, or monetary charges that may be incurred and that my access privilege may be terminated. Company Name: Typed or Printed Name of Owner or Officer: Title: Authorized Signature: Date: FCRA REQUIREMENTS Federal Fair Credit Reporting Act (as amended by the Consumer Credit Reporting Reform Act of 1996) Although the FCRA primarily reg...
