Application for non-member credit bureau service contract. The Undersigned (hereinafter referred to as the Applicant Credit Bureau) petitions the Credit Bureau named below (hereinafter referred to as the _________ Credit Bureau) for the use of its services upon the basis outlined below, and if accepted by said _________ Credit Bureau as a non-member user of service, agrees that the following shall constitute the service contract between the Applicant Credit Bureau and the _________ Credit Bureau. The Applicant Credit Bureau certifies that inquiries will be made only for the purposes of credit granting or other purposes defined by Public Law 91-508 as permissible, and the Applicant Credit Bureau agrees to identify to the _________ Credit Bureau each request for a report which is to be used for employment purposes, and to identify each request for a report which is to be used for a legitimate business need as defined in that law, in Section 604(3)(E). THE APPLICANT CREDIT BUREAU FURTHER AGREES: That reports on employees will be requested only by the Applicant Credit Bureau's designated representative. Employees will be forbidden to attempt to obtain reports on themselves or associates, or on any other person except in the exercise of their official duties. That all information or reports requested from the _________ Credit Bureau, whether written, printed or oral will be requested only in strict conformity to the Fair Credit Reporting Act (Public Law 91-508) and other applicable statutes, state or federal and disseminated to the Applicant Credit Bureau's customers or subscribers only in strict conformity to law(s). That in relaying any and all information or reports received from the _________ Credit Bureau to its subscribers or users, the Applicant Credit Bureau shall in all instances faithfully transmit such information or reports in their entirety, including but not limited to transmitting the date the information was last checked or revised by the _________ Credit Bureau and the full name and mailing address of the _________ Credit Bureau. That the identity of the ultimate recipient of each report will be provided to the _________ Credit Bureau. That it will (1) require the ultimate recipient to give advance notice to the consumer that a report may be requested for employment purposes, and (2) identify to the _________ Credit Bureau each request for a report to be used for employment purposes at the time such report is requested. That in case the disclosure of any information or reports by the Applicant Credit Bureau or by its subscribers or users leads to any claims or litigation, the
Applicant Credit Bureau agrees to indemnify the _________ Credit Bureau for any liability, damages or expense resulting therefrom. The _________ Credit Bureau shall not be liable in any manner whatsoever for any loss or injury to Applicant Credit Bureau resulting from the obtaining or furnishing of such information, such information being based, however, upon reports obtained from sources considered by the _________ Credit Bureau to be reliable. That the Applicant Credit Bureau will pay promptly for all reports or information requested, according to the rate schedule of cash prices now or subsequently established by the _________ Credit Bureau, plus the charges for any special telephone or telegraph services or other special services rendered. THE _________ CREDIT BUREAU AGREES: To maintain files on individuals, firms or corporations, recording information furnished by its members or subscribers or obtained from other available sources. To furnish all available pertinent information on individuals, firms or corporations, including but not limited to: identifying information, credit history, employment and public record information in file; such information being furnished at the special request of Applicant Credit Bureau, as evidenced by the signature of this application. IT IS MUTUALLY AGREED that this service contract, if accepted by the _________ Credit Bureau, shall remain in force and effect for one year and thereafter, from year to year, on the same basis as set forth herein until written notice of cancellation shall be given by either party at least 10 days prior to cancellation. It is further agreed, however, that if the Applicant Credit Bureau is delinquent in the payment of charges, or is guilty of violating the terms of this contract, the _________ Credit Bureau may, at its election, discontinue providing service to the Applicant Credit Bureau and cancel this contract immediately by written notice to the Applicant Credit Bureau. Dated at _________, this day _________[date] Applicant Credit Bureau Name _________ By _________ Title _________(Owner, Corporate Officer, Partner, or Manager) Address _________ Zip Code _________
Telephone _________ Bank References _________ Trade References _________ Persons to be authorized to request Credit Reports _________ Accepted for the _________ Credit Bureau named below By _________ Title _________ Date _________ Non-Member Credit Bureau Identification Number Assigned _________