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

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. The last 4 digits of the Subject’s Social Security Number. – Only required by Agero
4. States and counties where the Subject has resided in the past 10 years.

If you do not see your company on the list of companies, then do not proceed.  Email our office with your company name, address, phone, email and the name of the contact person.  We will then add you to the list.  Thank you

 

    Company: *required

     
    Subject's Info:

    First Name: *required
    Middle Name: *required
    Last Name: *required
    Maiden name or other last name(s) used in the past 10 years:
    Additional charges will apply. Each name is a separate search.
     
    Date of Birth:
    Month: *required
    Day: *required
    Year: *required
     
    Last 4 Digits of SS#: -REQUIRED by 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 in the past 10 years.*required
    OregonIdahoWashingtonOther 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 the Subject been convicted of a crime (Felony or Misdemeanor) in last 10 years?

    YesNo Felony or Misdemeanor Convictions in the last 10 years. *required

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

    Record Search Option: *required

    Criminal Record Search only.Add Non-Criminal Violation & Infraction Search +$5 per state (OREGON and IDAHO only).Add Sex Offender Registry Search +$5 REQUIRED by AGERO.Add Sex Offender Registry Search and Non-Criminal Violation & Infraction Search (OREGON and IDAHO 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.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)