Agency Validation Form
Employer Details
Legal Name of the Company (Inc/LLC/Partnership):
*
Company Fed Id:
*
Account Manager / Recruiter's name:
*
Company Address:
*
Contact No (prefixed with country code)
Eg: +1-248 285 5660:
*
Account Manager email ID:
*
Candidate Full Name:
*
Candidate Skill set:
*
Candidate Phone No:
*
Candidate Email ID:
*
If the consultant is on H1B Visa, Name of the firm holding H1B (
Valid I-797 need to be shown as proof
)
*
Will the consultant be available for
in-person
interview?
Yes
No
Desired Hourly/Monthly(Corp-to-Corp) Rate:
*
Invoicing
:
Payment Terms (30
:
30)?
Yes
No
Do you have Workers Compensation & Employers Liability Insurance?
Yes
No
Do you have General Liability Insurance ?
Yes
No
By submitting this form, I certify information provided above is true and complete and I authorize verification of all information
..
*
*
mandatory fields
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