Cluso Account Request Form
Company Information
Legal Company Name
Company name as legally filed including any corporate structure (e.g. LLC or Inc.).
DBA
If your company has a DBA or assumed name list that here.
Filing Country
-- Choose a Country --
United States
The country where the business is filed.
Filing State
-- Choose a State --
The state where the business is filed.
Filing Structure
-- Choose a Filing Structure --
The company filing structure.
Other Filing Structure
The filing structure.
Publicly Traded?
Yes
No
Choose whether the company is publicly traded or not.
Ticker Symbol
Your company's ticker symbol.
Federal EIN
List the company's federal EIN
(Format: 00-0000000)
D-U-N-S Number
List the company's D-U-N-S Number, if applicable
Industry Type
-- Choose an Industry Type --
The company industry type.
Other Industry Type
Other industry type not listed.
Main Phone
The company's main phone number.
Main Fax
The company's main fax number.
Company Website
The company's website.
(Format: https://www.example.com)
Physical Street Address
The street address of company's physical address.
Suite
The suite of company's physical address.
Country
-- Choose a Country --
United States
The country of company's physical address.
State
-- Choose a State --
The state of company's physical address.
City
The city of company's physical address.
Postal
The postal code of company's physical address.
Is your office a commercial location?
Yes
No
Choose whether the company is located in a commercial building.
In the office location, are you sharing a physical office with a different company in which that company has physical access to your computer equipment or files?
Yes
No
Choose whether the company has shared access space.
Is there a sign on your main door?
Yes
No
Choose whether the company has a sign on the main door.
Is there a directory in the building with your name?
Yes
No
Choose whether the company is listed in the building directory.
Do you have your sales Tax Permit showing in your office?
Yes
No
Choose whether the company sales tax permit is visible in the office.
Company Documents
Clear
Clear
Please upload company proof documentation. Examples include:
Business License
Articles/Certificate of Incorporation, Org, or Partnership
Proof of Regulation and/or insured by OCC, Fed Reserve, FDIC, or NCUA
Proof of 501(c) Status
EIN Confirmation Letter from the IRS
Company Principals
Principal 1
First Name
Principal 1 First Name
Last Name
Principal 1 Last Name
Title
Principal 1 Title
Phone
Principal 1 Phone
Email
Principal 1 Email
Principal 2
First Name
Principal 2 First Name
Last Name
Principal 2 Last Name
Title
Principal 2 Title
Phone
Principal 2 Phone
Email
Principal 2 Email
Principal 3
First Name
Principal 3 First Name
Last Name
Principal 3 Last Name
Title
Principal 3 Title
Phone
Principal 3 Phone
Email
Principal 3 Email
Add Principal
Delete Principal
Account Owner
First Name
Account Owner First Name
Last Name
Account Owner Last Name
Title
Account Owner Title
Phone
Account Owner Phone
Email
Account Owner Email
Account Users
User 1
First Name
User 1 First Name
Last Name
User 1 Last Name
Title
User 1 Title
Phone
User 1 Phone
Email
User 1 Email
User 2
First Name
User 2 First Name
Last Name
User 2 Last Name
Title
User 2 Title
Phone
User 2 Phone
Email
User 2 Email
User 3
First Name
User 3 First Name
Last Name
User 3 Last Name
Title
User 3 Title
Phone
User 3 Phone
Email
User 3 Email
Add User
Delete User
Invoicing Information
Billing/Phisical Address Same?
Yes
No
Is the billing and physical address the same?
Invoice Email
List the invoice email
Billing Street Address
The street address of company's billing address.
Suite
The suite of company's billing address.
Country
-- Choose a Country --
United States
The country of company's billing address.
State
-- Choose a State --
The state of company's billing address.
City
The city of company's billing address.
Postal
The postal code of company's billing address.
Additional Questions
How did you hear about us?
Referred by Cluso Client
Received Direct e-Mail from us
Received Postcard from us
Google or other Search Engine
Social Media
WBC, NAWB, WPO or Women Owned
TAB
76092 Magazine
HumanResources.com
Other
How did you hear about us?
If Referred, list by whom
The name of the person or company who referred you.
Approximately How many backgrounds do you expect per year?
Under 50
51-100
101-500
501-1000
1000+
Choose your volume expectations
If you have a Promo Code, enter here
Enter a promo code here if you have one.
Background Check Questions
Please list specifics for the type of background you need to perform for your first background and/or drug test
Statewide Criminal
County-Level Criminal
Federal Criminal
National Criminal (Stored DB)
Sex-Offender Search
Global Watch Lists
County Civil
Employment Verifications
Education Verifications
Reference Verifications
License/Certification Verifications
10-Panel Drug Screen
Driving Records
List the requirements for your first background check
List any other requirements below
If you are complying with another company's requirements, you may list those here
If you have a copy of the requirements, you can upload here
Clear
If you have a copy of the requirements, you can upload here.
For a complete list of services/rates please visit
http://www.cluso.com/rates
Human check: 3 + 7 =
Enter the sum of 3 plus 7
PRESS HERE TO SUBMIT YOUR NEW ACCOUNT REQUEST