Name* First Middle Last Address* Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Zip Home County*AndersonAndrewsAngelinaAransasArcherArmstrongAtascosaAustinBaileyBanderaBastropBaylorBeeBellBexarBlancoBordenBosqueBowieBrazoriaBrazosBrewsterBriscoeBrooksBrownBurlesonBurnetCaldwellCalhounCallahanCameronCampCarsonCassCastroChambersCherokeeChildressClayCochranCokeColemanCollinCollingsworthColoradoComalComancheConchoCookeCoryellCottleCraneCrockettCrosbyCulbersonDallamDallasDawsonDeWittDeaf SmithDeltaDentonDickensDimmitDonleyDuvalEastlandEctorEdwardsEl PasoEllisErathFallsFanninFayetteFisherFloydFoardFort BendFranklinFreestoneFrioGainesGalvestonGarzaGillespieGlasscockGoliadGonzalesGrayGraysonGreggGrimesGuadalupeHaleHallHamiltonHansfordHardemanHardinHarrisHarrisonHartleyHaskellHaysHemphillHendersonHidalgoHillHockleyHoodHopkinsHoustonHowardHudspethHuntHutchinsonIrionJackJacksonJasperJeff DavisJeffersonJim HoggJim WellsJohnsonJonesKarnesKaufmanKendallKenedyKentKerrKimbleKingKinneyKlebergKnoxLa SalleLamarLambLampasasLavacaLeeLeonLibertyLimestoneLipscombLive OakLLanoLovingLubbockLynnMadisonMarionMartinMasonMatagordaMaverickMcCullochMcLennanMcMullenMedinaMidlandMilamMillsMitchellMontagueMontgomeryMooreMorrisMotleyNacogdochesNavarroNewtonNolanNuecesOchiltreeOldhamOrangePalo PintoParkerParmerPecosPolkPotterPresidioRainsRandallReaganRealRed RiverReevesRefugioRobertsRobertsonRockwallRunnelsRuskSabineSan AugustineSan JacintoSan PatricioSan SabaSchleicherScurryShackelfordShelbyShermanSmithSomervellStarrStephensSterlingStonewallSuttonSwisherTarrantTaylorTerrellTerryThrockmortonTitusTom GreenTravisTrinityTylerUpshurUptonUvaldeVal VerdeVan ZandtVictoriaWalkerWallerWardWashingtonWebbWhartonWheelerWichitaWillbargerWillacyWilliamsonWilsonWinklerWiseWoodYoakumYoungZapataZavalaHome PhoneCell Phone*Email* Enter Email Confirm Email How long have you been serving civil process?* Are you Certified by the JBCC to servce civil process in Texas?* Yes No Please provide your PSC#*Have you ever had a complaint filed against you with the PSRB?* Yes No Please explain* Have you ever served Texas Attorney General Child Support papers?* Yes No What counties and how many average a month* Do you currently owe Child Support?* Yes No Have you ever worked for a process serving company before?* Yes No What companies and for how long* Rate you ability using a computer and internet:*ExcellentGoodFairPoorAre you currently working for another process serving company?* Yes No What Company, how long & what service area (county/zip) are you currently covering for them* Are you knowledgeable with filing of pleadings with your local Clerk's office* Yes No Do you have high speed internet at your house?* Yes No Do you have a smart phone or tablet with a data plan?* Yes No Are you currently employed?* Yes No Please give the name of current employer & days & hours you work* Are you HUB certified?* Yes No Please provide your HUB certification#*Are you certified in any of the below certifications?8(a)DBEMBESBENon-MinorityPlease list Certification Entity* Will you be applying for Full/Part time work?* Full Time Part Time What days (excluding Sundays) and hours are you available to work?* What type of vehicle do you drive?* How many papers can you handle on average per month?* What service areas (county/zip codes) are you intrested in covering*
