Guarding West Gate | Request Background Check

AGREEMENT REQUESTING THAT GUARDING THE WEST GATE CONDUCT A BACKGROUND REVIEW WHICH WILL BE PLACED IN A SEALED ENVELOPE ATTACHED TO YOUR PETITION FOR INITIATION AND ADVANCEMENT

The Guarding the West Gate Portal is for background reviews within the United States of America, for backgrounds outside the United State of America please contact the Tiler@gardingthewestgate.com directly for additional information and discussion of fees.

The fee for the background review is $16.00. PayPal or Credit Card is the preferred method of payment; all payments are processed and protected by PayPal or Square. Guarding the West Gate does not have access to the Petitioners credit or debit card information.

Background Review Fee: $16.00

SECURE GENERAL INFORMATION

Petitioner’s First Name*

Petitioner’s Last Name*

Petitioner’s Nickname

Complete Current Address*

City

State

Zip Code

Social Security Number*

(Required)

Reenter Social Security Number*

(Required)

Date of Birth*

Place of Birth*

Gender

Race

Current Phone Number*

Cell Number*

E-mail Address*

Name & Number of Lodge where the Petition is to be submitted*:

Lodge City & State*

Select Grand Lodge*

Have you ever been arrested by Federal or Military Law Enforcement?

If yes, lists dates, locations and which Federal or Military Agency

List the charges that were alleged against you?

Were you convicted in Federal or Military Court?

If Yes, what charges were you convicted of?

Have you ever been arrested by a State, County, City, Town or Village Law Enforcement Agency?

If Yes, list dates, locations and which Law Enforcement Agency?

List the charges that were alleged against you?

Were you convicted in State, County, Town, City or Village Court?

If Yes, what charges were you convicted of?

Are you required to register on any offender registries?

If yes, which state or county registry?

SECURE BILLING INFORMATION

First Name*

Last Name*

Address*

City*

State

Zip Code

Phone Number*

E-mail Address*

Payment Type

SECURE PAYMENT INFORMATION

By providing my personal information and paying for this service I acknowledge and agree to the following:

The Guarding the West Gate Portal is for background reviews within the United States of America. For backgrounds outside the United State of America please contact the Tiler@gardingthewestgate.com directly for additional information and discussion of fees.

The fee for the background review is $16.00. PayPal Pro is the preferred method of payment; all payments are processed and protected by PayPal Pro or Square. Guarding the West Gate does not have access to the Petitioners credit or debit card information. The payment will show on your billing statement as Pasquale Imbimbo, Private Detective. Please inform your spouse of this payment so I do not have to explain to your spouse that you did not hire us to investigate her. This is not a joke and has occurred several times. Thank you.

The information I entered is true and accurate; I am requesting this service for the sole purpose of using the report generated by this service to assist in the filing of my Masonic Petition/Membership for Initiation and Advancement in a Masonic Lodge or Affiliated Masonic Entity. If a report is needed for another purpose besides Initiation and Advancement of a Petition for a Masonic Lodge, or Affiliated Masonic Entity, I fully understand that I may contact Guarding the West Gate at tiler@guardingthewestgate.com for discussion.

I am requesting this service using my personal information and that I am the person requesting this service be performed. I understand that misuse of the Guarding the West Gate Portal or the Report generated by my request in any form may result in Criminal Prosecution and/or Litigation as well as Masonic Investigation.

I understand that providing false and or fraudulent information on my Petition or application requesting a Guarding the West Gate report may result in disqualification for membership in a Masonic Lodge or any Masonic Entity.

I understand and hereby acknowledge that no promises or guarantees have been expressed orally or in writing relating to the outcome of this service. I understand that the information contained in any report may not be complete. The information is gathered from a variety of legally accessed sources, public and private, and that The Grand Lodge of New York, Prince Hall Grand Lodge, The Grand Lodge of the District of Columbia, Guarding the West Gate, and Pasquale Imbimbo, Private Detective, their agents and employees have no control over and such information or data is subject to human error, merger of data through computers, or common key stroke or entry errors.

I understand that accuracy of the data and information gathered and discovered is limited to the information and accuracy of the information provided by me.

I understand, promise and guarantee that I have the legal authority to request this service and the results of the requested services will be used legally and securely. I understand that once Guarding the West Gate transmits the background review report to me, that I am responsible for the security of the report and associated information contained within.

I furthermore understand that once I file a Petition for Initiation and Advancement within a Masonic Lodge or Entity, that a particular Masonic Lodge, Grand Lodge or Masonic entity may communicate with Guarding the West Gate for confirmation.

I furthermore give my consent allowing Guarding the West Gate and its employees and agents to provide the contents of my background review report and associated information to the Grand Lodge of New York or the Grand Lodge of the District of Columbia or the Grand Lodge or Prince Hall Grand Lodge or the Grand Lodge of Connecticut or Masonic Lodge or Masonic Entity of which I am seeking membership.

I hereby release, hold harmless, discharge and exonerate the agents, employees and representatives of Guarding the West Gate, Pasquale Imbimbo, Private Detective and the Grand Lodge of the State of New York and the Grand Lodge of the District of Columbia and the Grand Lodge of Connecticut and the Prince Hall Grand Lodge and other Grand Lodge or any Masonic Lodge or Masonic Entity from any and all liability, of every nature and kind, arising out of the Background Review process or the Background Review Report furnished to me or to the Masonic Lodge or Masonic Entity that I have voluntarily submitted my Petition and Background Review to for consideration for membership.

By my submission of this request for a background review, by providing my personal information and submitting a payment for the requested service, I acknowledge that I have read the forgoing document, and all the documents And provided information on the Guarding the West Gate Portal and that I fully understand the contents contained within and voluntarily request a Background Review Report.

I understand that if I have any questions or do not understand any of the information provided above or presented anywhere on the Guarding the West Gate Portal/Website, I will contact Guarding the West Gate at Tiler@guardingthewestgate.com before submitting my personal information and making a payment.

Take Notice, Guarding the West Gate does not store any secure Order/Payment information. The secure checkout is processed and protected by PayPal Pro or Square, which you decide to use.

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