Form 89 images: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by entering your printed name in the designated field, followed by your date of birth and Social Security Number (SSN). Ensure accuracy as this information is crucial for verification.
In the section labeled 'I am conducting the following business transaction', specify the purpose of your request. For example, if it's for a pre-employment background check, clearly state that along with any additional details required.
Fill in the company name and contact information accurately. This includes the name of the company requesting verification and their address.
If applicable, provide details about the company's agent responsible for handling your request. Include their name and address as required.
Sign and date the form at the bottom. Make sure to initial if you wish to change the consent validity period from 90 days.
Lastly, complete your contact information including your address, city/state/zip code, and phone number to ensure proper communication.

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