Test EMP Add a User Form

Add an Authorized User.

You are here because your company has contracted with Western Reporting to provide background checks and they have requested to add you as an authorized user to their account.

Please fill out the form completely. (5 min) Make sure you read and understand the agreements before you e-sign them. Misuse of the data you receive through Western Reporting can open you up to fines, imprisonment, and/or civil lawsuits.

If you have any questions while filling out the Add an Authorized User form, don’t hesitate to contact us.
Western Reporting

8789 S. Highland Dr. Suite 300

Sandy, UT 84093

Phone: 801-308-0005 Fax: 801-308-0015

Toll-free phone: 800-466-1996 Toll-free fax: 800-351-4558
Business Name
Authorized Account Users Information
Authorized User's Legal Name
Authorized User's Title
Authorized User's Physical Work Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Work Number

Area Code Phone Number
Fax Number

Area Code Phone Number
E-mail
________________________________________________________________
Western Reporting End User Service Agreement

Click to expand and read each section.
Authorized User - Accept Documents and eSign
Consent and Notice Regarding Electronic Signatures and Electronic Communication

I Accept
Signed Receipt of Documentation: Western Reporting End User Service Agreement

I Accept
eSignature format: "Type your legal name"
Date (Click Today on calender)

Month Day Year
E-mail
Title
Physical Work Address: (Address including city, state, and zip code)
After eSigning: Scroll down, Press [Save] to save the form. Exit the form by closing the browser tab or window.
Format for printing
Should be Empty:

Authorized Account Users Information

Western Reporting End User Service Agreement