Investigation / Surveillance Request Form

Please fill out the below form as completely as possible and click "Submit" when finished.
You will receive an e-mail confirmation of your submission.
All fields marked with an asterisk (*) are mandatory.

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Form Object
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Terms & Conditions: The REQUESTOR appoints and authorizes ICU Detective Agency as its AGENTS to conduct the requested checks: Information herein is for the sole use of the REQUESTOR based upon his/her representation that the inquire is for legitimate permissible purpose as defined in the Fair Credit Reporting Activity, Freedom of Information Activity, Fair Housing Activity or other applicable laws or regulations. REQUESTOR agrees to make all notices as required by those acts. All information has been obtained from sources believed to be reliable, but whose accuracy is not guaranteed. REQUESTOR agrees to indemnify and hold harmless ICU Detective Agency from any damages arising out of any improper use of this information, and it is furnished in reliance on that indemnity. REQUESTOR agrees to hold all information provided in strict confidence, and not to reveal it to anyone, including the applicant of the request, except as allowed by federal or state law.