New/First Time 10 Year Background Check

To complete this form you will need:

1. The Subject’s current address.
2. A copy of the Subject’s state driver’s license.
3. States and counties where the subject has resided in the past 10 years.

    Company:*required

    Subject's Info

    First Name: *required
    Middle Name: *required
    Last Name: *required
    Maiden Name or other last names ONLY if used in the past 10 years:
    Additional charges will apply charges. Each name is a separate search.

    Date of Birth:
    Month: *required
    Day: *required
    Year: *required

    Driver's License #: *required
    State where License was issued (e.g., Oregon) : *required

    Current Residential Address:
    Street: *required
    City: *required
    State: IdahoOregonWashington*required
    Zip: *required

    SELECT ALL STATES THE SUBJECT HAS RESIDED AND WORKED WITHIN THE PAST 10 YEARS.*required
    IdahoOregonWashingtonOther States

    If subject has resided or worked outside of the above selected states in the last 10 years, you are required to list the state, and county the subject resided and worked in the last 10 years. You are required to ask the subject for this information.

    State (1):
    County (1):

    State (2):

    County (2):

    State (3) :

    County (3):

    State (4):

    County (4):

    State (5):

    County (5):

    Has subject been convicted of a crime (Felony/Misdemeanor) in last 10 years?

    Select One*required

    YesNo Felony or Misdemeanor Convictions in the last 10 years.

    List State, County, Type, and Date of Conviction:

    Record Search Option:*required

    Criminal Record only.Criminal Record, Non-Criminal Violation & Infraction (OR,ID only) +$5 per state.Criminal Record, Sex Offender Registry +$5Criminal Record, Sex Offender Registry, Non-Criminal Violation & Infraction (OR,ID only) +$10.

    Invoice / Receipt handling:*required

    Email the invoice/receipt and results.Fax the invoice/receipt and results.Mail the invoice/receipt and results.

    Your Identity:*required

    My name is and...

    I am the OWNER of the above business. I had a copy of the subject's driver's license available when I filled out this form. I also asked the subject to provide me with a 10 year address history prior to filling out this form. Please invoice me for this request.I am the MANAGER of the above business. I had a copy of the subject's driver's license available when I filled out this form. I also asked the subject to provide me with a 10 year address history prior to filling out this form. Please invoice me for this request.I am the SUBJECT of the background check. I am applying to work for the above company. I have a valid drivers license and I am filling out this form. I also understand I need to provide a list of all states and counties I have lived and worked in the last 10 years. I understand if I fail to list my address history correctly I may not qualify for employment. Invoice/receipt will be sent to the company selected. EXCEPT for NW NANNIES, PRE-PAYMENT IS REQUIRED. I understand this search will not be started until I send payment to PI Services or until I make a payment on this website, for NW Nannies request.

    A confirmation email will be sent to the following email.: *required
    (This email address will be kept confidential)

    Answer Quiz: (to reduce spam)