C.E.R.T. Application
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1. Please enter your full, legal name

Please enter your full, legal name

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2. Please enter your date of birth. mm/dd/yyyy

Please enter your date of birth. mm/dd/yyyy

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3. Please enter the last four digits of your Social Security number.

Please enter the last four digits of your Social Security number.

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4. Please enter your driver's license or ID number. ex: Txx-xx-xxxx

Please enter your driver's license or ID number. ex: Txx-xx-xxxx

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5. Please enter your physical adress

Please enter your physical adress

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6. Please enter a telephone number where we can reach you.

Please enter a telephone number where we can reach you.

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7. Do you agree to a full background check?

Do you agree to a full background check? Yes

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