Dispute Accuracy Of My Background Check

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Company Name*

First Name*

Last Name*

Email*

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Disputed Case(s)*

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Specific Case(s) (comma separated)

Reason(s) for Dispute*

Discrepancy: Level of Charge

Discrepancy: Offense Description

Discrepancy: Disposition/Verdict

Disputed Identity

Expunged Case

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Supporting documents*

There will be a link to your cover sheet on the next page. Please fax your supporting documents to (910) 815-3881.

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