Application for membership and service contract. In order to cooperate with other business and professional people in the confidential dissemination of credit information, the undersigned (hereinafter referred to as the Applicant) 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 member or subscriber, agrees that the following shall constitute a service contract between the Applicant and the Credit Bureau. THE APPLICANT AGREES: To pay herewith the sum of _________ Dollars, ($_____), as an initial fee, for which the Applicant is to receive _________ To pay each _________ a membership fee of $_____ which shall be in addition to the regular service charges, for which the Applicant is to receive _________ To pay the Credit Bureau $_____ per month payable in advance on the first of each month. The first payment shall be due on the first day of the calendar month next succeeding date of acceptance of the service contract by the Credit Bureau. That said monthly payment shall entitle Applicant to an equivalent amount of credit information according to the schedule of charges now or subsequently established by the Credit Bureau during the month for which said payment is made, and that if the charges for the information requested should exceed the minimum monthly payment, Applicant will pay, when billed, all charges in excess of the monthly minimum payment. The Applicant will comply with all the provisions of Public Law 91-508 (Fair Credit Reporting Act) and all other applicable statutes, both state and federal. That information will be requested only for the Applicant's exclusive use, and the Applicant certifies that inquiries will be made only when the Applicant intends to use the information for a permissible purpose, namely: (A) In connection with a credit transaction involving the consumer on whom the information is to be furnished and involving the extension of credit to, or review or collection of an account of, the consumer; or (B) For employment purposes; and Applicant agrees (1) to give advance notice to the consumer that a report may be requested for employment purposes, and (2) to identify to the Credit Bureau each request for a report to be so used at the time such report is requested; or (C) In connection with the underwriting of insurance involving the consumer; or (D) In connection with a business transaction involving the consumer; and the Applicant agrees to identify to the Credit Bureau each request at the time such report is ordered, and to certify the legitimate business need for such report. Reports on employees will be requested only by the Applicant's designated representatives. Employees will be forbidden to attempt to obtain reports on themselves, associates, or any other person except in the exercise of their official duties. (Public Law 91-508 provides that any person who knowingly and willfully obtains information on a consumer from a consumer reporting agency under false pretenses shall be fined not more than $5000 or imprisoned not more than one year, or both.) To furnish the Credit Bureau with written or oral information giving the following data: (A). The names and addresses of customers whose accounts have been restrained or closed by Applicant (and the reasons therefor); or placed for collection; or repossessed; or charged off as a loss. (B). Information on active and inactive accounts and any pertinent other information to make the Credit Bureau's files more complete, immediately when requested by the Credit Bureau. (C). Such pertinent information on present or former employees as may be requested by the Credit Bureau. That applicant will use its best efforts to provide prompt, accurate and complete information, but it is expressly understood by both parties to this agreement that Applicant does not warrant the accuracy or completeness of the information furnished to the Credit Bureau. All information received from the Credit Bureau, whether written, printed or oral, is for the exclusive use of Applicant, and in case the disclosure of such information leads to any claims or litigation, to hold the Credit Bureau harmless from any liability, damages or cost or expense including reasonable attorney's fees resulting therefrom. The Credit Bureau shall not be liable in any manner whatsoever for any loss or injury to Applicant resulting from the obtaining or furnishing of such information and shall not be deemed to have guaranteed the accuracy of such information, such information being based, however, upon reports obtained from sources considered by the Credit Bureau to be reliable. 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, as evidenced by the signature on this application. IT IS FURTHER MUTUALLY agreed that the Credit Bureau and the Applicant shall each be liable to any third party claimant for its own acts of negligence with regard to the performance of its duties hereunder, and each shall indemnify and hold harmless the other for and from all such third party claims arising on account of its acts of negligence, or on account of its failure to perform any of its obligations hereunder, and any cost or expense, including reasonable attorney's fees, incurred by the other in connection therewith. Dated at _________, this day _________[date] Applicant _________ By _________ Title _________ Address _________ Zip Code _________ Type of Business _________ Telephone _________ Bank References _________ Trade References _________ Person to be Authorized to Request Credit Reports _________ Accepted for the Credit Bureau Named Below By _________ Date _________ Deposit _________ Code Number Assigned _________