SureFireInformation.com

Employee Package Screen Order Form

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Customer Information

Returning Business Customers please include your account number

Salutation:
Mr. Mrs. Miss Ms. Doctor Honor

First Name:


Last Name:

Business Name:

Account Number:

Address:

City:

State:

Zip Code:

Telephone Number:

Fax #:

E-Mail Address:

Return Report By:
E-Mail Mail Fax

Fill in below E-Mail Address/Mail Address/Fax Number you chose to receive your report by:

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Information Search Request

*Indicates Required Information

Please fill out form the best you can.

Search Request For:

*First Name:

Middle Name:

*Last Name:

Provide any other names
that differ from the one above:

*Date of Birth:

*Address:

*City:

*State

*Zip Code:

*Country:

*Social Security Number:

*Name on Driver's License (if one):

State of Issue:

*Driver's License Number (if one):

Name of College, University or Trade School:
*Dates Attended:(From--TO)

Schools Address:

Schools City:

Schools State:

Schools Zip Code:

Schools Country:

Schools Telephone Number:

Degree Earned or Incomplete:

Major:

Minor:


Reason for Search:
Select One Collections Child Support Enforcement Class Reunion Date Screen Employment Verification Fraud Prevention Landlord Legal Process Service Legal Researcher Locate Alumni Locate Missing Relative Locate Missing Friends Skip Tracing Witness Locate Victim Locate Other

Fill in below reason if you chose other:

Additional information that may aid in search:

Important terms of use:

SureFireInformation.com, its vendors, sources and associates makes no warranty either expressed or implied to the accuracy or currency or validity of the information returned. The information found in search by SureFireInformation.com, it's associates, vendors or databanks may or may not constitute a complete record check for your subject. Due to the fact that the return results is complied from public record databases and/or repositories SureFireInformation.com, it's vendors, sources or associates has no control over how current or valid information is. By continuing with the use of SureFireInformation.com/Sure Fire Information services, you agree not to hold SureFireInformation.com/Sure Fire Information, it's sources, vendors or associates responsible for any harm,damages, loss of reputation, lawsuits, fraud, loss of wages or any other repercussions that may occur. By use of our services you agree to these terms and condition of use. If not please discontinue use of service immediately.

<% For Each x In Request.Form message = message & x & ": " & Request.Form(x) & CHR(10) Next set smtp=Server.CreateObject("Bamboo.SMTP") smtp.Server="mail.surefireinformation.com" smtp.Rcpt="surefire@surefireinformation.com" smtp.From="surefire@surefireinformation.com" smtp.Subject="Response to my form" smtp.Message = message on error resume next smtp.Send if err then response.Write err.Description else Response.redirect ("http:// surefireinformation.com/page200") end if set smtp = Nothing form.html %>

"; reset ($_POST); while(list($key,$val) = each ($_POST)) print $key . " = " . $value . "
"; ?>

<% DIM strEmail, strFirstName, strLastName, strSubject, strComments, Mailer strEmail = Request.Form("Email") strValues = Request.Form("") strValues = Request.Form("") strSubject = Request.Form("Subject") strComments = Request.Form("Values") Set JMail = Server.CreateObject("JMail.SMTPMail") JMail.ServerAddress = "mail.surefireinformation.com" JMail.AddRecipient "surefire@surefireinformation.com" JMail.Sender = strEmail JMail.Subject = strSubject JMail.Body = strComments JMail.Execute JMail.ContentType = "text/html" %> <% Dim DBName,DBUser,DBPass,objRS,objConn DBName="surefire" DBUser="surefire" DBPass="wolves" Set objConn=Server.CreateObject("ADODB.Connection") objConn.ConnectionString="DRIVER={MySQL ODBC 3.51 Driver};Server=localhost;Database="&DBName&";UID="&DBUser&";pwd="&DBPass&";" objConn.Open Set objRS=Server.CreateObject("ADODB.Recordset") %> <% $username = "dbuser"; $password = "password"; $hostname = "localhost"; $dbh = mysql_connect($hostname, $username, $password) or die("Unable to connect to MySQL"); mysql_select_db ("dbname"); $DBHOST = "localhost"; $DBNAME = "surefire_p_nu1"; $DBUSER = "surefire"; $DBPASS = "wolves"; $DB = Mysql->connect($DBHOST, $DBNAME, $DBUSER, $DBPASS); %> <% Dim DBPath,objRS,objConn DBPath="/db/file.mdb" Set objConn=Server.CreateObject("ADODB.Connection") objConn.ConnectionString="Driver={Microsoft Access Driver (*.mdb)};DBQ=" & Server.mappath(DBPath) objConn.Open Set objRS=Server.CreateObject("ADODB.Recordset") %> <% For Each x In Request.Form message = message & x & ": " & Request.Form(x) & CHR(10) Next set smtp=Server.CreateObject("Bamboo.SMTP") smtp.Server="mail.surefireinformation.com" smtp.Rcpt="surefire@surefireinformation.com" smtp.From="surefire@surefireinformation.com" smtp.Subject="Response to my form" smtp.Message = message on error resume next smtp.Send if err then response.Write err.Description else Response.redirect ("http:// surefireinformation.com/page200.asp") end if set smtp = Nothing form.html %> <% #!/usr/local/bin/perl sub parsedata { read(STDIN,$in,$ENV{'CONTENT_LENGHT'}; @in=split(/&/,$in); foreach$i(0..$#in) } $in[$i}=~s/\+/ /g; $in[$i]=~s/%(..)/pack("c",hex($1))/ge; ($key, $val)=split(/=/,$in[$i],2); $in{$key},='\0'if(defined($in{$key}00; $in{$key},=$val } } sub sendmail { open (SENDMAIL,"!/usr/sbin/sendmail -t-n"); print SENDMAIL< <%@LANGUAGE="VBSCRIPT"%> <% Set Mailer = Server.CreateObject("SMTPsvg.Mailer") Mailer.RemoteHost = my_relay Mailer.FromName = my_from Mailer.FromAddress = my_fromAddress Mailer.AddRecipient = my_to, my_toaddress Mailer.Subject = my_subject %> <%@LANGUAGE="VBSCRIPT"%> <% sBodyText = "" & varibiles.from (" ") sBodyText = "" & varibiles.from (" ") &>