Employer Enrollment

To complete the enrollment process, please fill out the following form. Once we enroll you with E-Verify, we will fax you the MOU (Memorandum of Understanding) for your company to sign. You need to fax back ONLY the last 3 pages (with signature). We will forward that signed document to the Department of Homeland Security. It generally takes 1–2 days to have your company added to an approved list of E-Verify participants. You will then be ready to order your E-Verify searches.

Note: All fields marked with an * are required!

Company Information

Company Name: *

Parent Organization Name (if different):

Employer ID Number: *

This is your Federal Tax ID number.

Data Universal Numbering System (DUNS) Number:

First 3 Numbers of Your Company's Primary NAICS Code:

If you don't know your NAICS code we will find it during the enrollment process.

Physical Address

Address: *

City: *

State or Territory: *

Zip or Postal Code: *

Country: *

Mailing Address (if different)

Address:

City:

State or Territory:

Zip or Postal Code:

Country:

Primary Contact Person

Full Name: *

Phone Number: *

E-Mail Address: *

Fax Number: *

Company Demographics

Number of Employees: *

This can be an approximate number.

Number of Hiring Sites: *

Please list each state and the number of sites within it.

FAR-E-Verify

Check this box if your company contracts with the Federal Government or has sub-contracts with companies that have a FAR-E-Verify clause in the contract.

How would you like to submit the form?

E-Mail

Print and Fax

Submit