Zip Reports Tenant Screening Application

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Client Application and Contract
General Information:
	Name ("Subscriber") (First, Middle, Last)	A value is required. A value is required.
	Company (if applicable)	A value is required.
	Number of rental units
	Property #1 Location (Address, City, State)
	Property #2 Location (Address, City, State)
	Property #3 Location (Address, City, State)
	Estimated number of reports per year
	Subscriber address:
	Address 1	A value is required.
	Address 2
	City / State / Zip	A value is required. Valid zipcode is requiredValid zipcode is required
	Phone	A phone number is required.
	Fax
	E-Mail	An email address is required.Invalid email format.
	Billing Address: (same as above: )
	Address 1
	Address 2
	City / State / Zip
	Credentials:
	User ID Requested (minimum 8 characters,at least 1 number)	User name must not begin with a digit
	Password Requested (minimum 8 characters,at least 1 number)	A password is required.Minimum of 8 characters is required.
	Retype Password Requested
FCRA Notice:
	By checking this box I acknowledge that I have received a copy of and read the following so-entitled documents, and understand and accept full responsibility for implementation of their contents: — Access Security Requirements for using Credit Information — FCRA Requirements — Notice to Users of Consumer Reports: Obligations of Users under the FCRA By checking this box I acknowledge that I have received the following document from ZipReports and Subscriber will give a copy to Applicants when required: A Summary of Your Rights under the Fair Credit Reporting Act By checking this box I acknowledge that I ("Subscriber") recognize that credit bureau regulations limit each account to being used to pull reports for a SINGLE purpose. I ("Subscriber") agree to only pull reports through this account for the ONE purpose: "Tenant Screening for Properties owned by self". By checking this box I acknowledge that I ("Subscriber") accepts full responsibility for compliance with all applicable regulations and laws. Subscriber acknowledges that the summaries provided by ZipReports are furnished primarily as a courtesy and simply highlight obligations of End Users of consumer information, and that such summaries are not meant to be an exhaustive representation of applicable state or other laws, nor of Subscriber’s End Users’ responsibilities under such laws. "Under Section 621 (a) (2) (A) of the FCRA, any person that violates any of the provisions of the FCRA may be liable for a civil penalty of not more than $2,500 per violation."			This is required to establish an account.
	If I ("Subscriber") wish to pull credit reports from a location(s) within the following states and/or on their residents , I have checked the appropriate states and will submit the corresponding form(s) to ZipReports with my application.
	— California: End User Certif. of Compliance – Calif. Civil Code, Sect. 1785.14(a)			This is required to establish an account.
	— Vermont: Notice of Requirement for Consumer Consent			This is required to establish an account.
Acceptance by Subscriber
	By checking this box I understand and agree with the following: I understand and agree that throughout this New Client Application and Contract (ZipReports contract), “Subscriber” refers to the entire entity applying to receive services through ZipReports, and any and all of the entity’s constituents—not solely the entity’s representative(s) completing this form. I understand and agree that “I” refers to myself as a representative of the Subscriber, and I certify that I am authorized to and do enter into this New Client Application and Contract for and on behalf of the Subscriber, and that all information contained herein is complete and accurate to the best of my knowledge. I understand and agree that the individual listed as the Account Contact Person will be the person designated to authorize requests for additional end user sub-accounts for the Subscriber, as needed and as permitted by this New Client Application and Contract. Subscriber may also designate other individuals to have this authority. I certify that credit information Subscriber receives through ZipReports will not be used for any purpose not listed herein as one of the Subscriber’s business roles for which the Subscriber will be requesting reports. By submitting this New Client Application and Contract, I attest that I have read, understand, and agree to all the terms and conditions contained herein. I agree that a fax,copy, or electronic transmission of this document shall be as valid as the original, and that checking this box will carry the weight of my signature.			This is required to establish an account.
Referred by:
	How were you referred to ZipReports?	Google	Zip Reports Website
		ZipReports Sales	Web search (other than Google)
		AptMag.com	ApartmentGuide.com
		Rent.com	Other
		Existing Client	Client name:

	I am interested in ordering:	Criminal and Eviction only	Credit, Criminal and Eviction Package
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