[ Microfax - Getting Started ]

Microfax is dedicated to making this process simple and user-friendly. If you have any questions or concerns, please Contact Us. Microfax is dedicated to ensuring your privacy. Read our Privacy Statement.

Process Overview
1. You must agree to the Microfax User Agreement .
2. After you agree, you will be presented with a Microfax Membership Subscriber Form which will allow you to subscribe to Microfax services.
3. As a subscriber to Microfax services you will have access to the file library, which provides you with the necessary forms for employee screening services, such as drug testing and DMV records.

Microfax Pre-Employment Screening Subscriber Application

Organization Name:			# Years Established:
Physical Street Address:	(PO Box or Private Mail Box not permitted.)
City:			State: Zip:
Main Telephone:	(###-###-####)	Main Fax:	(###-###-####)

Type of Business/Industry:
Federal Employer Identification Number (FEIN):			Is your organization exempt from state and local taxes?
State of Incorporation:			Is your organization home-based?
Organization Website Address (URL):			Stock Symbol: (if applicable)

User Contact Information

User access information will be provided to the primary contact only. Account information and Training Guides are frequently e-mailed to New Users. Please provide the correct e-mail address for user and account correspondence.

Email:
Name:		Title:		Telephone:	(###-###-####)

Person responsible for hiring:

Name:

Title:

Telephone:

(###-###-####)

Billing Information

My billing address is the same as my street address
Billing Address:
City:	State:	Zip:

Bank Information may be required from new applicants, a Microfax representative will contact you if this information below is needed to process your account application.
Bank Name:		Bank Address:
Phone:	(###-###-####)	Fax:	(###-###-####)
Bank Account Type:		Bank Account Number:

Billing Contact Information

Name:

Title:

Telephone:

(###-###-####)

Billing Method

Would You Like to Pay by Credit Card? Yes No

(Invoice customers - setup time will be delayed. New Users must qualify for this payment method - expect an additional 24-48 hours for activation.)

Please review your credit card number carefully. Failure to enter the card number correctly may delay your account approval.
Credit Card Number:	(no dashes or spaces)	Expiration Date:	(format: MMYY)
Name on Credit Card:
CSC (Card Security Code) on Credit Card:	CSC Information
Microfax accepts Visa, Mastercard and American Express Credit Cards

Questionnaire

Please take a moment to answer these questions.

How many employees work at your organization?
How did you hear about our services?
Are you authorized by your organization to order reports for employment purposes?
How many people in your organization will be using this account?
Will you be requesting access to Motor Vehicle Reports?
Will you be requesting access to Credit Reports?
Please describe the nature of your business. (Maximum of 250 characters)

How will you be using the information provided through our service? (Maximum of 250 characters)

The information submitted on this Subscriber Application and Service Agreement will be used to determine eligibility in accessing information provided by Microfax, Inc. Microfax.Inc. reserves the right to reject this Agreement for any reason whatsoever without explanation, or recourse against Microfax, Inc. and/or its employees or officers. Additionally, the applicant hereby authorizes Microfax, Inc. to independently verify the information provided herein. As part of your application for services, we may be required to verify bank/credit information, business or client references on your organization.

By clicking submit you are agreeing to the terms described above.