General Investigation Form - Stryker Investigation Services Inc.

General Investigation Form - Stryker Investigations

Questions? Call: (800) 733-1950

CLIENT INFORMATION

ATTORNEY / LAW FIRM NAME/ CLIENT NAME: *

Today's Date:

CLIENT NAME / REQUESTOR NAME/ PERSON REQUESTING SERVICE:

Email Address: *

CONTACT PERSON (paralegal or associate attorney) & POSITION

REPRESENTATIVES AUTHORIZED TO SIGN FOR THE COMPANY OR FIRM:

EMAIL ADDRESS OF REPRESENTATIVES AUTHORIZED TO SIGN THE AGREEMENT:

INVOICE PROCESSING AND PAYMENT EMAIL ADDRESS:

Office Phone

Direct / Private Line

Cell Phone

Address *

Comments

Due Date

Client File# / Client Name:

Civil Case#

*RUSH ASSIGNMENT

INDIVIDUAL'S INFORMATION (SUBJECT INFO)

SUBJECT: Name (First, Last) *

SUBJECT: Date of Birth

SUBJECT'S: Social Security Number

SUBJECT'S SPOUSE: Name (First, Last) *

SPOUSE'S: Date of Birth

SUBJECT'S MOST RECENT OR CURRENT: Address

SUBJECT'S: Previous Address

PROFESSIONAL OCCUPATION / EMPLOYMENT:

INFORMATION:

INVESTIGATION SEARCH REQUESTED: Client Must Identify Desired Search

PREVIOUS ADDRESS:

KNOWN VEHICLES:

SPECIAL INSTRUCTIONS FOR AGENCY - SPECIFIC INFORMATION FOR INVESTIGATION

Upload Documents

Maximum file size: 30MB

METHOD OF PAYMENT | PAYMENTS ARE DUE BEFORE SERVICE IS PROVIDED.

E-INVOICE | Electronic invoice through Square. Pay with your credit card, Apple Pay, Google Pay.

ACH INVOICE | Electronic invoice through Square. Pay with your credit card, Apple Pay, Google Pay, or ACH bank transfer.

Name of Representative Authorizing Services *

BY SUBMITTING THIS FORM TO THE AGENCY, YOU AFFIRMATIVELY AGREE TO THE FOLLOWING: 1. LIMITATIONS OF USE AND LIABILITY 2. ALL INFORMATION IS CORRECT. Limitations of Liability. While the information contained in the report(s) provided has been obtained from records data sources deemed reliable, its accuracy cannot be guaranteed due to potential human error in the actual recording of the records. Since this information is not owned by Stryker Investigation Services Inc., and since records data on any one individual, group of individuals, company, or companies can be contained in more than one repository, Stryker Investigation Services Inc., can only rely on its accuracy from the records data sources presently available at the time of the search. This information is furnished for your exclusive use and accepted by you without any liability whatsoever on the part of Stryker Investigation Services Inc., its sources, officers, agents or employees. Furthermore, you agree to indemnify Stryker Investigation Services Inc., its sources, agents, and employees of any liability for the use of this information.

CLOSING COMMENTS:

We sincerely appreciate your confidence in Stryker and look forward to the privilege of working with you on this assignment.

If you have any questions, please call us at (800) 733-1950

Thank you for this assignment.

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