To create an account for your company, print this page and fill in the blanks.
Creating an E-Verify account is free, no setup charge, nor any monthly charge -- just $10.00 per query.
To register your company, please fill in the blank fields and return by FAX 520-300-7026.

PLEASE PRINT CLEARLY WITH THICK DARK INK

NAME OF YOUR COMPANY  

DBA (if different than company name)  

FEDERAL (NOT STATE) EIN (EMPLOYER IDENTIFICATION NUMBER)  

APPROXIMATE NUMBER OF EMPLOYEES  

COMPANY FACILITY STREET ADDRESS (include city state & zip)
(Usually where applicant interviews take place)  



Address 2  

COUNTY OR PARISH (NOT COUNTRY)

COMPANY MAILING ADDRESS (include city state & zip)
(If different than street address)  



PARENT COMPANY (If any)  

DOES OR WILL YOUR COMPANY CONTRACT WITH THE FEDERAL
GOVERNMENT  (circle one) Yes or No 

DOES OR WILL YOUR COMPANY CONTRACT WITH YOUR STATE
GOVERNMENT (circle one)  Yes or No

DOES OR WILL YOUR COMPANY CONTRACT WITH YOUR CITY
GOVERNMENT  (circle one) Yes or No 

NUMBER OF HIRING SITES IF MORE THAN ONE
 (These are secondary locations of the same company where interviews will also take place)  

NAME OF PRINCIPAL COMPANY CONTACT: (person who makes
major company decisions -- not necessarily hiring administrator)  

TITLE OF PRINCIPAL COMPANY CONTACT: (e.g.: President, Owner, Etc.)  

NAME OF HIRING ADMINISTRATOR (if different than Principal contact)
Can be any peson assigned to the hiring process - usually HR)  

COMPANY EMAIL ADDRESS  

TELEPHONE NUMBER  

FAX NUMBER  

1] To complete the registration process, fax this completed page back to us: 520-300-7026

2] The DHS (Dept of Homeland Security) will tentatively approve your registration pending your agreement with an MOU (Memorandum Of Understanding) which we will fax or email to you shortly for your approval (usually approved the same day).

Once signed up with E-Verify, you only fax (or scan and email) a copy of any new hire's I-9 to use. We do the rest.

QUESTIONS? Phone 602-548-0183 or Email [email protected]