NFOSAFE Verification Services

NFOSMART INC.

NFOSAFE Verification Solution - Creating a Safer & Smarter Online Experience
1. Entity President Name*

First NameLast Name
2. Entity Name*
Enter your business name incorporated or used for tax purposes.
3. EIN #*
Enter numbers only.
4. Years Entity Exist?*
Enter the number of years the entity exist.
5. Entity Type*
Please select your current business type.
6. Entity Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
YesNo
8. Your Entity Website*
Website accuracy is very significant. Website example: zmusic.com.
9. Your Entity Email*

Confirmation EmailEnter your entity email address. Email example: john@zmusic.com
10. Your Mobile Number*
Please enter a valid mobile number.
YesNo
12. Provide the name of the person or entity that referred you.
If referred by a person, please provide First and Last name.
YesNo
14. Provide the name of your Association, Trade, etc.
Enter your association, trade, etc. legal name.
15. Provide the number of years you have been a member.
Enter the number of membership years in organization provide above.
16. Provide the phone number to Organization you listed as a member.
Enter your organization's phone number.
17. Person Completing and Submitting Application*

First NameLast Name
18. Your Job Title with Entity Named Above*
We need your job title because you are completing and submitting application on behalf of entity named above.
19. Contact number to reach Person Completing and Submitting Application*
Please enter a valid mobile number.
Date*

MonthDayYear
Date

NFOSAFE Verification Solution*

NFOSAFE Verification Solution

Annual Fee is $175! First payment is due with the Application. Customer is not on automatic billing. Customer will be billed when next annual payment is due.

$175 one-time payment

Credit Card

Should be Empty:

NFOSMART INC.

Credit Card