SERVICE REQUEST APPLICATION
SABER SECURITY, LLC
Please Print and Fax to 603-826-4771
Telephone - 603-826-4773
Company Name: Requested By:
Date: Telephone Number: Fax Number:
Authorization for Release of Information:
In connection with my employment/tenancy, application for employer/tenancy, or contract for services with this company, I fully understand that this release acknowledges that this company may now, or at any time while I am employed or a tenant, request a consumer report containing information for verification of backround and personal character. I authorize and request all persons, schools, businesses, corporations, credit bureaus, courts, law enforcement, armed forces, employment commissions, and all governmental agenciesto release said information without restriction or qualification. I authorize a photostat of this release to be considered as effective and valid as the original.
This release shall include, but not be limited in its scope or purpose for reasons of business necessity. All results will be proprietary and kept confidential and will not be provided to any parties other than this company or its legal representatives. I hereby declare the answers to the questions on my application and any attachments to be true and correct; that any misstatement of fact or omission may be the basis for rejection or revocation of my application for employment/tenancy. I have the right, with proper identification, to dispute the accuracy or completeness of any information obtained in my report/files with Saber Security LLC/Intelnet,Inc. does not make or recommend employment/tenancy decisions pertaining to my consumer report. To obtain a copy of my report or contest the content, I may call 1-888-636-3693.

This company does not discriminate as to race, color, gender, national or religious origin, age, or The Americans with Disabilities Act. I authorize Saber Security LLC/Intelnet,Inc. to provide the results of my consumer report to this company or its representatives. I further release this company and Saber Security LLC/Intelnet, Inc., their officers, employees, and agents from any and all liability arising from the results and preparation of my consumer report. I have read or have had read to me this release form and I understand, consent, and agree to authorize the execution of this release in full by my signature on this date.
Services Requested:
Criminal History
Civil History
SS Trace
MVR/Driving History
Employment History*
Education History*
*Include a resume and application
Income Range:
Under $75,000
Over $75,000
Signature: Date: Witness:
First Name Middle Last Name Maiden Name
Social Security Number Gender Date of Birth
Driver's License Number State Position
Current Address City State How Long?
Previous Address City State How Long?
Previous Address City State How Long?
Previous Address City State How Long?
Counties to be Researched (To be completed by Agent) Company