New/First Time 10 Year Background Check for AAA OR/ID

To complete this form you must have the following in your possession:

1. Subject’s current address.
2. A copy of the subject’s State Driver’s License.
3. A list of States and Counties the subject has lived in the past 10 years is required.

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, each name is a separate search.
 
Date of Birth
Month: *required
Day: *required
Year: *required
 
SS#: (not required for AAA, required for Agero)
Driver's License #: *required
State of License: *required
 
Current Residential Address
Street: *required
City: *required
State: OregonIdahoWashington *required
Zip: *required

 
LIST ALL STATES THE SUBJECT HAS RESIDED AND WORKED WITHIN THE PAST TEN YEARS.*required
OregonIdahoWashingtonOther States (list state & county below)

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:
County:
 
State:
County:
 
State:
County:
 
State:
County:
 
State:
County:

 

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.

If Yes, list State, County, Type, and Date of Conviction:

Select One *required

I ONLY want the required Criminal Search preformed.Criminal search request and I would like to add a Statewide Violation and Infraction Search (Non-Criminal). +$5 additional per state, only available in OR and ID.Criminal search request and I would like to add a Nationwide and Statewide Sex Offender Registry Search. +$5 additional.(required for Algero)Criminal search request and I would like to add a Statewide Violation and Infraction Search. I would also like to add a National and Statewide Sex Offender Registry Search. +$10 additional.

Select One *required

Send invoice/receipt with results via Email.Send invoice/receipt with results via Fax.Send invoice/receipt with results via US Mail.

Select One *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.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 use the following email address for correspondence with me: *required
(This email address will be kept confidential)

Answer Quiz: (to reduce spam)