CKI Litigation request form

Please enter the information in the fields below. After completing the form please click on "Submit" to send your request directly to us. Your request will be securely transmitted to CK Investigations and someone will contact you upon receipt.

If you have any questions or problem on how to fill out this form, please e-mail us at support@ckinvestigations.com for assistance.

	Client Information
	Contact Name
	Company Name
	Address
	City
	State
	Zip Code
	Telephone
	Fax
	E-mail

	Applicant Information
	Applicant's Full Name
	Address
	City
	State
	Zip
	Social Security #
	Date of Birth
	Sex		Male Female
	Telephone

	Social Security Verification
	Yes No

	Consumer Credit Report
	Yes No

	Federal Criminal Records
	Yes No

	Statewide Criminal History
	State #1
	State #2

	County Criminal Records
	County #1
	County #2

	First Employer
	Employer's Name
	Address
	City
	State
	Zip Code
	Telephone
	Applicant's Start Date
	Applicant's End Date
	Applicant's Supervisor

	Second Employer
	Employer's Name
	Address
	City
	State
	Zip Code
	Applicant's Position
	Applicant's Start Date
	Applicant's End Date
	Applicant's Supervisor

	Third Employer
	Employer's Name
	Address
	City
	State
	Zip Code
	Telephone
	Applicant's Position
	Applicant's Start Date
	Applicant's End Date
	Applicant's Supervisor

	Education Verification
	Institution Name
	Address
	City
	State
	Zip Code
	Telephone
	Date of Attendance
	Degree/Diploma

	License Verification
	License Number
	State

	License Verification
	Driver's License #
	State

	Neighborhood Interviews
	Comment: Neighborhood Interviews are only conducted within the New York Area. ( Five Boroughs, Westchester, Rockland & Putnam Counties)

	How would you like your report & photos delivered? Choose all that apply.


	Additional Instructions