On The QT                                                                                                                               Date:
11862 Balboa Blvd #401, Granada Hills, CA 91344

Re: Request For Employment Background Investigation

       Name of Applicant/Employee:

                        Social Security No.:       DOB:

Dear Sir;

 Please initiate an Employment Background Investigation (EBI) for us on the above named employee/applicant.  The resulting report of investigation should be forwarded to at the above address.  The undersigned is authorized to bind the company with respect to this transaction, and certifies that:

1.                  The purpose of this Employment Background Investigation is:     To Evaluate A Job ApplicantPeriodic Re-Investigation of Employee.

2.                  We have completed the required Method of Payment Form, and attached same to this request. We have also attached your Employment Background Services Request Form to identify the specific inquiries we want you to perform as part of this investigation.

3.                  We have attached a copy of your Employee/Applicant Information Form that was completed by the applicant/employee or, in lieu of that form, have attached a copy of our company's application form, annotated to identify specific fields we need to have verified as part of this Employment Background Investigation.

4.                  In accordance with the requirements of the Fair Credit Reporting Act (FCRA), the undersigned hereby certifies on behalf of as follows:

a.       We would like to order an Employment Background Investigation Report (also known as a "Consumer Report") from you regarding the above-named applicant/employee. 

b.      The report is for employment purposes and will be used for no other purpose.  We will not use information in the report in a manner that violates federal or state equal employment opportunity laws or regulations.

c.       We have notified the applicant/employee that we might order such a report and we have obtained the applicant/employee's written consent to obtain said report.  The attached Applicant/Employee Authorization To Obtain Information Form has been signed and dated by the applicant/employee, and a signed copy will be forwarded to you by mail or facsimile.

d.      If the report you provide to us pursuant to this request contains unfavorable or derogatory information about the applicant/employee, we will provide the applicant/employee with a copy of your report and a copy of the FCRA summary of his/her rights, if requested, before taking adverse action, if any, against the applicant/employee.

         The above information is true and complete to the best of my knowledge.

          ___________________________    _____________________________   _____________
                           Printed Name                                              Signature                                              Date

Encl: (4)

Form Instructions for Form Letter, Request for Employment Background Investigation

1.      Enter your company's name, address, city/state/zip, and telephone number in the header.

2.      Fill in all  informational blanks in the form.

3.      Print the form from your browser, and proof read.

4.      Sign the form letter you printed out and mail or fax it to us.  We need a signed letter and the four Attachments listed above before we can proceed.

5.      Enclose the following:
    Employment Background Investigation Service Request Form
     Method of Payment Form
     Employee/Applicant Identification Information Form or  Company Application Form
     Initial Notice and Consent To Obtain Background Investigation Reports signed  by Applicant/Employee