Directions: 1) Fill Out Information. 2) Print Out Form . 3) Sign The Bottom Of The Form
4)
Fax It To - 305-253-8334
-
You May Fax Orders 24 Hours A Day - 7 Days A Week
THIS AGREEMENT is made and entered into on this
day of
, 19
, by and between T-R INFORMATION SERVICES of 12805 SW 91 Ct., Box #10, Miami, FL 33176 (hereinafter referred to as "TRIS") and
(hereinafter referred to collectively as "CLIENT.")
TRIS agrees to perform the following information searches for CLIENT:
SUBJECT
:
S/S#:
ADDRESS
:
IDENTIFYING DATA:
D/O/B
:
D/L#:
INFORMATION REQUESTED:
1)
$
2)
$
3)
$
The total estimated cost for these searches will be$
. CLIENT is fully responsible for these charges which are payable in full to TRIS within ten (10) days of receipt of information. ADDITIONAL COSTS will not be charged without CLIENT's prior knowledge and consent.
Credit Card
Exp
(VISA, MC, AMEX)
I, the undersigned cardholder, give permission to TRIS to use the above credit card for payment of the above search(s). If I choose, I may pay TRIS by check or money order where in this authorzation will be void. I also understand that if no payment is received by TRIS within the terms stated above, TRIS will charge my card for the full amount. Client also agrees to pay any attorney's fees and court costs which we may incur in collecting any unpaid amount and agrees to pay any attorneys fees and court costs incurred by TRIS in defending any lawsuit brought by client or client's representatives.
TERMS AND CONDITIONS:
This agreement is made subject to the following terms, conditions & understandings:
TRIS will make reasonable efforts to locate the requested information and will make reasonable efforts to check the accuracy of any information provided. Since TRIS does not prepare the underlying records its retrieves, it cannot guarantee the accuracy, timeliness or completeness of the information provided. TRIS only guarantees that it will furnish all the information it has retrieved. TRIS shall not be liable for any loss or injury resulting from the use of, failure to provide, or delay in receiving, such data. In the event that no information can be obtained on the subject matter(s) through our agreed efforts, CLIENT shall nevertheless be responsible for the payment of all fees agreed to be paid as specified above.
GENERAL USE OF DATA
: CLIENT agrees that the information supplied by TRIS strictly for its own use, and that this information will not be used by CLIENT for any purposes prohibited by any governmental laws, statutes, ordinances, rules and/or regulations.
C
OMPLIANCE WITH THE FAIR CREDIT REPORTING ACT
: CLIENT agrees that any requested reports or information which maybe covered by the FAIR CREDIT REPORTING ACT must be used in full compliance with the terms and intentions of that ACT. CLIENT recognizes and understands that the FAIR CREDIT REPORTING ACT provides that anyone "who knowingly and willfully obtains information on a consumer from a consumer reporting agency under false pretenses shall be fined not more that $5,000 or imprisoned not more than one year, or both."
ANY FACSIMILE
of this duly signed and executed agreement shall be deemed to be and shall serve as if it were the original agreement between the parties, providing all legal rights and remedies under the governing law of the STATE OF FLORIDA or other applicable governmental authorities.
Client Signature: X___________________________________________
Client Name:
Address, City, ST, Zip:
Phone with Area Code:
Send Information by E:mail
Fax:
Payment by Credit Card
Payment By Check (must have credit card back-up)