CustomerTrack Startup Form by bHw9MIQV


									                                                   Your Prospects Dealer Startup Form

         Dealership Name:
        Legal Corp. Name:
           Federal Tax ID:                                  -
            Contact Name:
                GM Name:
          Name for Mailer:
          Phone for Mailer:
     Email Responses To:
       Fax Responses To:
           Dealer Address:
                       City:                                                                           State:                             Zip:
                    Phone: (                                 )-          -                              Fax: (                  )-         -
     Number of Prospects:                                                                 Cost:                                                      Includes CT/RO
   Customer Track & Rapid
            Qualifier Only?
          Criteria Requested:

                                                                  Monday:               to       p.m.                   Tuesday:             to        p.m.
             Hours for B.D.C.:                                  Wednesday:              to      p.m.                   Thursday:             to       p.m.
                                                                    Friday:             to      p.m.                   Saturday:              to       p.m.
                                                                                              Sunday:             to       p.m.
           Terms of Payment:

                   Additional Info:

                                                                    MEMBER AGREEMENT [USA]
  1.) Complimentary mail pieces to send to the prospects containing a 24/7 “800” #, and website where consumers can apply. 2.) Live 24/7 operators to take applications
  and set appointments as specified by the dealer. This is a month-to-month agreement, and may be cancelled by either party without cause with 5 days written notice to
 other. Renewal of this agreement must be authorized by an authorized representative of the dealer via fax or e-mail. All auto lead counts are tabulated between the 26th
  and 25th of proceeding month. Any renewal invoices are due and payable the 10th of each month. Both parties in this agreement agree to abide by all state and federal
 regulations pertaining to the handling of consumer information generated by this program. Complimentary mail pieces provided by Customer Track, LLC, are to be used
   solely for prospects delivered to the dealer by Customer Track, LLC, and for no other purpose. In addition the mail pieces can only by mailed to a prospect one time.
 Customer Track, LLC, will not provide or share any data used in this program with any third parties. So long as this agreement is in effect the dealer can download their
data once each billing cycle. All disputes arising from this agreement shall be resolved in the courts of Florida. Reseller hereby consents to Florida State court jurisdiction
   and Pinellas County, Florida venue on all actions. Business Resellers’ obligations shall be deemed to be personal obligations of the individual signing the Agreement.
   Unpaid balances bear interest at 1.5% per month. AGREEMENT: I/ We certify the foregoing to be true and correct. I/ We have been advised of the terms of services,
which are set forth herein . I/ We agree to pay all attorney fees and costs incurred if this account requires enforcement or collection, whether or not an action is filed with a

     Print Name: ________________________________ Title: _____________________

        Signature: ________________________________ Date: July 6, 2012

                                                       PLEASE PRINT & SIGN THIS AGREEMENT.
                                       FAX THE SIGNED AGREEMENT TO (231) 773-0379 TO COMPLETE REGISTRATION.

              Your Prospects • 3135 State Rd 580 Suite 13, Safety Harbor, FL 34695 • 1.888.251.8843 •

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