Promo Code: _______________
RECORDSCHECK.NET APPLICATION AND AGREEMENT
Steps to submit your application:
The information submitted on this application and agreement will be used to determine eligibility for accessing information provided by RecordsCheck.net. RecordsCheck.net reserves the right to reject this application and agreement without recourse against RecordsCheck.net or any of its employees, officers, agents or affiliates or other staff. Additionally, the applicant hereby authorizes RecordsCheck.net to independently verify the information provided herein.
Section A: Company Information
Official Company Name _______________________________________________________
D/B/A (If Any) ______________________________________________________________
Address __________________________________________________________________
City _______________ State ___________ Zip ___________________________________
Telephone (____) __________________ Website (if any) ____________________________
Section B: Account Contact Information
First Name __________________Last Name _____________________Title______________
Telephone (____) _____________ Ext. ________ Fax (______) ________________________
Email Address ___________________________
Section C: Company Principals
Principal(s) of Company
First Name __________________ Last Name _________________ Title ________________
First Name __________________ Last Name _________________ Title ________________
First Name __________________ Last Name _________________ Title ________________
Dun and Bradstreet Number (If Any) _____________________________________________
Section D: Type of Business
___ Corporation ___ Sole Proprietor ___ Partnership/LLC State of ______________
Federal Tax ID Number _______________________________________________
Business/Professional License Number (If Any)
Date Issued/Expiration Date ___________________ Town/City Issued _______________
County Issued ______________________________ State Issued ____________________
Section E: Industry Class (What best describes your business – Select One)
___ Attorney/Law Office ___Insurance ___ Banking ____ Media
___ Landlord Management Company ___ Collections ___ Government
___ Process Server ___ Human Resources ____ University
____Other (Specify) __________________________
Section F: GLB Acceptable Uses (Check all that apply - At least one must be checked)
The information that RecordsCheck.net provides to the end user may contain consumer identification information governed by the Gramm-Leach-Bliley Act (GLB) . In accordance with GLB, such information may only be used for the following purposes:
___ Completion of a transaction authorized by the consumer including but not limited to (a) collection of delinquent accounts, (b) employment application information verification, (c) property leasing application information verification , (d) insurance application information verification. Fair Credit Reporting Act (15 U.S.C. ss 1681 et seq.) rules apply.
___ Law Firm and attorney functions
___ Insurance Purposes including (a) account administration, (b) reporting, (c) fraud prevention, (d) premium payment processing, (e) claim processing and investigation, (f) benefit administration, (g) research projects.
___ Fraud prevention and detection
___Required institutional risk control/dispute resolution for resolving
subscriber disputes or inquiries
Section G: Non-GLB Acceptable Uses (Check all that apply
- At least one must be checked)
_____ Fraud Prevention
_____ Child support enforcement
_____ Uniting separated families
_____ Locating missing persons and heirs to estates
_____ Locating pension fund beneficiaries
_____ Consumer protection
_____ Locating organ and bone marrow donors
_____ Promoting the integrity of the political process
_____ Significant journalistic endeavors
_____ Apprehending criminals
_____ Other legitimate business use
_____ Debt collection
_____ Investigations in civil litigation
Section H: Drivers Privacy Protection Act (DPPA) - (Check all that apply - At least one must be checked)
Some information that RecordsCheck.net provides to the end user may be subject to DPPA rules and regulations. In accordance with the DPPA, such information may only be used for the following purposes
______ For use by any government agency, including any court or law enforcement
agency, in carrying out its functions, or any private person or entity acting
on behalf of a Federal, State, or local agency in carrying out its functions.
______ For use in connection with matters of motor vehicle or driver safety
and theft;motor vehicle emissions; motor vehicle product alterations, recalls,
or advisories;performance monitoring of motor vehicles, motor vehicle parts
and dealers; motor vehicle market research activities, including survey
research; and removal of non-owner records from the original owner records
of motor vehicle manufacturers.
______ For use in the normal course of business by a legitimate business
or its agents, employees, or contractors, but only --
(A) to verify the accuracy of personal information submitted by the individual
to the business or its agents, employees, or contractors; and
(B) if such information as so submitted is not correct or is no longer correct,
to obtain the correct information, but only for the purposes of preventing
fraud by, pursuing legal remedies against, or recovering on a debt or security
interest against, the individual.
______ For use in connection with any civil, criminal, administrative, or
arbitral proceeding in any Federal, State, or local court or agency or before
any self-regulatory body, including the service of process, investigation
in anticipation of litigation, and the execution or enforcement of judgments
and orders, or pursuant to an order of a Federal,State, or local court.
______ For use in research activities, and for use in producing statistical
reports, so long as the personal information is not published, re-disclosed,
or used to contact individuals.
______ For use by any insurer or insurance support organization, or by a
self-insured entity, or its agents, employees, or contractors, in connection
with claims investigation activities, anti-fraud activities, rating or underwriting.
______ For use in providing notice to the owners of towed or impounded vehicles.
______ For use by any licensed private investigative agency or licensed
security service for any purpose permitted under this subsection.
______ For use by an employer or its agents or insurer to obtain or verify
information relating to a holder of a commercial driver's license that is
required under the Commercial Motor Vehicle Safety Act of 1986 (49 U.S.C.
App. 2710 et seq.).
______ For use in connection with the operation of private toll transportation
facilities
______ For any other use in response to requests for individual motor vehicle
records if the motor vehicle department has provided in a clear and conspicuous
manner on forms for issuance or renewal of operator's permits, titles, registrations,
or identification cards, notice that personal information collected by the
department may be disclosed to any business or person, and has provided
in a clear and conspicious manner on such forms an opportunity to prohibit
such disclosures.
______ For bulk distribution for surveys, marketing or solicitations if
the motor vehicle department has implemented methods and procedures to ensure
that --
(A) individuals are provided an opportunity, in a clear and conspicious
manner, to prohibit such uses; and
(B) the information will be used, rented, or sold solely for bulk distribution
for surveys, marketing, and solicitations, and that surveys,marketing, and
solicitations will not be directed at those individuals who have requested
in a timely fashion that they not be directed at them.
______ For use by any requester, if the requester demonstrates it has obtained
the written consent of the individual to whom the information pertains.
______ For any other use specifically authorized under the law of the State
that holds the record, if such use is related to the operation of a motor
vehicle or public safety.
This service agreement ("Agreement") by and among RecordsCheck.net ("RecordsCheck.net") and applicant, hereafter referred to as ("Subscriber"). Subscriber is granted a limited license to access RecordsCheck.net's on-line data retrieval system known as the ("Network") and the information therein, on the following terms and conditions:
1. SERVICE - RecordsCheck.net provides nationwide public record information, document retrieval and related services ( the "Services") through it's proprietary databases and from information obtained from third parties. Subscriber hereby subscribes to Services and agrees to pay RecordsCheck.net the applicable rates and charges assigned to each individual search as set forth within the current price sheet. Subscriber also agrees that RecordsCheck.net may change the price of a search from time to time as so long as RecordsCheck.net posts the new pricing prior to actually doing so.
2. LIMITATION OF LIABILITY - SUBSCRIBER HEREBY AGREES TO BEAR THE RISK OF ANY LIABILITY RELATING TO ITS USE OF THE SERVICE. ACCORDINGLY, SUBSCRIBER'S USE OF THE ONLINE SYSTEM IS ENTIRELY AT ITS SOLE RISK. RecordsCheck.net WILL NOT BE RESPONSIBLE TO SUBSCRIBER OR ANY THIRD PARTIES FOR ANY DIRECT OR INDIRECT, CONSEQUENTIAL, SPECIAL OR PUNITIVE DAMAGES OR LOSSES SUBSCRIBER MAY INCUR IN CONNECTION WITH OUR SERVICE, SUBSCRIBER'S USE THEREOF OR ANY OF THE DATA OR OTHER MATERIALS TRANSMITTED THROUGH OR RESIDING ON OUR SYSTEM, REGARDLESS OF THE TYPE OF CLAIM OR THE NATURE OF THE CAUSE OF ACTION, EVEN IF WE HAVE ADVISED OF THE POSSIBILITY OF SUCH DAMAGE OR LOSS.
3. INDEMNIFICATION - Subscriber shall defend and indemnify RecordsCheck.net and hold it harmless from and against any and all claims, proceedings, damages, injuries, liabilities, losses, costs and expenses (including reasonable attorney's fees), relating to Subscriber's use of Services. Subscriber is aware of the sensitive nature of information contained in the Services, and that its use may be controlled under state and federal law. Subscriber acknowledges this assumption of risk, and neither RecordsCheck.net nor any third parties underwrites this risk in any manner whatsoever.
4. DISCLAIMER OF WARRANTY - THE SERVICE IS PROVIDED "AS IS" AND RECORDSCHECK.NET MAKES NO WARRANTIES, EITHER EXPRESS OR IMPLIED, AS TO THE MERCHANTABILITY, FITNESS FOR A PARTICULAR USE OR PURPOSE, TITLE, ON-INFRINGEMENT OR ANY OTHER WARRANTY, CONDITION, GUARANTY, OR REPRESENTATION, WHETHER ORAL, IN WRITING OR IN ELECTRONIC FORM, INCLUDING BUT NOT LIMITED TO THE ACCURACY OR COMPLETENESS OF ANY INFORMATION CONTAINED THEREIN OR PROVIDED BY THE SERVICE.
5. RESTRICTED LICENSE - RecordsCheck.net hereby grants to subscriber a restricted license to use the system in accordance with the acceptable use(s) identified by subscriber in the application and agreement. The application and agreement has identified industry specific appropriate uses for which it's services are to be used, and subscriber agrees to state its appropriate use for any requested information prior to accessing it, to limit its use to those stated purposes and to take appropriate measures so as to protect against the misuse of information provided pursuant to the services.
6. TERM OF AGREEMENT - The term of this Agreement shall extend from the date of RecordsCheck.net's acceptance, and shall continue until terminated without cause by either party upon thirty (30) days prior notice, or as otherwise provided herein. In the event Subscriber violates any portion of this agreement, RecordsCheck.net may immediately terminate this Agreement. Cancellation shall be the sole remedy available to Subscriber in the event of a default by RecordsCheck.net.
7. SUBSCRIBER'S COMPLIANCE WITH STATE AND FEDERAL LAWS - Subscriber shall not use the Network in a manner contrary to or in violation of any applicable federal, state, or local law, rule, or regulation, including but not limited to the Fair Credit Reporting Act (15 U.S.C.A. § 1681 et seq.), the Gramm-Leach-Bliley Act (GLB), and the Driver's Privacy Protection Act (DPPA). Misuse of the Service or Network shall constitute a material breach of this Agreement. Subscriber covenants that it will only use the Services for legitimate business purposes. Subscriber covenants that it will not use any credit information obtained by it through the Network as a factor in establishing consumer's eligibility for credit or insurance. subscriber hereby certifies to RecordsCheck.net that subscriber's use of certain identification-only products, including but not limited to credit header products, is pursuant to an exception under the GLB act as designated in Section F.
8. AUDIT - Subscriber understands and agrees that in order to ensure compliance with GLB, RecordsCheck.net will conduct occasional reviews of subscriber activity and may, on a random basis, contact subscriber to provide documentation of executed searches.
9. PAYMENT OF FEES - RecordsCheck.net currently utilizes an automated payment system that requires the subscriber to fund their account to conduct searches. Subscriber agrees that all credit card information that is input into the payment forms will be authorized by the individual whom the credit card is issued to. Subscriber also agrees that in the event of a dispute (chargeback), subscriber will bear all responsibility in satisfying the outstanding charge and a $25.00 (twenty-five dollars) processing fee.
I HEREBY CERTIFY that I am authorized to execute this application and agreement on behalf of the applicant listed above and that the statements I have provided in this application and agreement are true and correct. Further, I hereby certify that the applicant agrees to the terms and conditions set forth in this application and agreement.
APPLICANT
Signature ___________________________________
Print Name __________________________________
Title _______________________________________
Date _______________________________________