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B. PREVIOUS PLACES OF EMPLOYMENT, CHECKED (MEMBER)

1. NAME PHONE NUM. ( )

ADDRESS CITY ST ZIP

RESPONSE

2. NAME PHONE NUM. ( )

ADDRESS CITY ST ZIP

RESPONSE

3. NAME PHONE NUM. ( )

ADDRESS CITY ST ZIP

RESPONSE

4. NAME PHONE NUM. ( )

ADDRESS CITY ST ZIP

RESPONSE

C. DIRECTORIES CHECKED/CREDIT BUREAU REPORT

1. ADDRESS SEARCH N/R ( ) RESPONSE
2. PHONE NUM. SEARCH N/R ( ) RESPONSE
3. NAME-SPOUSE SEARCH N/R ( ) RESPONSE
4. SIMILAR LAST NAME N/R ( ) RESPONSE
5. NEIGHBOR SEARCH N/R ( ) RESPONSE
6. SS # SEARCH N/R ( ) RESPONSE
7. CITY DIRECTORY N/R ( ) RESPONSE
8. MORTG./LEASE/LANDLORD N/R ( ) RESPONSE
9. INSURANCE COM. (AGENT) N/R ( ) RESPONSE
10. UTILITIES CHECKED N/R ( ) RESPONSE
11. WEBSITE SEARCH N/R ( ) RESPONSE

D. LETTERS SENT
Date Sent Date Received Response
1. DEPT. OF LABOR

2. DEPT. OF MOTOR VEHICLES

3. EMPLOYMENT

4. RELATIVE/REFERENCE

5. POSTAL LETTER (TRACER)

6. CERTIFIED MAIL

7. ADDRESS CORRECTION REQ

8. MILITARY LOCATOR

9. GENERAL

L