Background Checks

Disclosure to employment applicant & staff regarding initial & annual procurementof investigative & driver's license reports.
Please be advised that we may obtain an investigative reportincluding information as to your character, general reputation, and personal characteristics. This informationmay be obtained by contacting your previous employers or references supplied by you. Please be advised that you have the right to request, in writing, within a resonable time, that we makea complete and accurate disclosure of the nature and scope of the information requested, Such disclosure will be made to you within 5 business days of the date on which we receive the request from you or within 5 business days of the time the report was first requested.
Full Name:



City/State/Zip Code:

Social Security Number:

Date of Birth:

Driver License Number:

Driver License STATE

Employer's Name

Contact Number

Contact Fax Number

Please check all that apply:
DL Report
State Criminal Background (please specify state)**

Nationwide Criminal Background(datebase)
SS Trace
Federal Criminal***
***Prior Years or States

Education Verification
Employment Verification
Credit Report

I am at least 18 years of age.
I am a legal guardian for the individual requesting this report****
****Name of Guardian

In compliance with consumer reporting and privacy legislation, I hereby authorize Southeastern Drug Testing Services to obtain a driver's license, criminal background, education, credit report, past employment or any other information needed for employment.

Payment Information
The service of ____ is required before your background check is retrieved. Please provide your billing information below; your card will not be processed immediately. If there is an issue with your payment, we will contact by phone and/or email.
Card Number:
Exp. Date: (MM/YY)
Security Number
Address Line 1:
Address Line 2:

About Us
Testing Solutions
Background Checks
My Account

Testing Solutions
Pre-Employment Drug Testing
Random Drug Testing
Post-Accident Drug Testing
Hair Folicle Drug Screen
Alcohol Testing

Contact Us
[Phone] (910)641-0037
[Fax] (910)641-0036

Office Location:
112 Premiere Plaza | Whiteville, NC 28472