E-Verify Required Info- Account Setup

Which category best describes your organization?

—Please choose an option—Federal Contractor with FAR E-Verify ClauseFederal Contractor without FAR E-Verify ClauseFederal GovernmentState GovernmentLocal GovernmentNone of the above

(Federal Contractors Only) Which Federal Contractor category best describes your organization?

—Please choose an option—Institution of Higher EducationState or Local GovernmentFederally Recognized Indian TribeSuretiesNone of these categories apply

(Federal Contractors Only) Which employees will your client company verify?

—Please choose an option—Entire Workforce(all new hires and existing employees throughout the entire company)All new hires and all existing employees assigned to a federal contract

Company

DBA Name (if applicable)

DUNS Number

Physical Location (Full Address)

County/Parish

Mailing Address (If Different From Above)

Employer Identification Number (AKA Federal Tax ID Number)

Total Number of Employees

—Please choose an option—1 to 45 to 910 to 1920 to 99100 to 499500 to 9991,000 to 2,4992,500 to 4,9995,000 to 9,99910,000 and over

Parent Organization (if applicable)

NAICS Code (You can find yours here: https://www.census.gov/naics/)

Will you be verifying for multiple sites or a single site?

—Please choose an option—MultipleSingle

If multiple, list the addresses of all hiring sites in each state. Or, download this CSV file and send it in to your account representative.

Company Point of Contact

Name

Phone Number

Email

Fax

Secondary Contact (Not Required)

Name

Phone Number

Email

Fax