e-VERIFILE.COM MVR Agreement

Motor Vehicle Subscriber Agreement
$25.00 Sign up Fee

e-VERIFILE.COM is pleased to provide access to Motor Vehicle Reports (MVR) through an agreement with the Insurance Information Exchange (iiX) for employment purposes. The ExpressNet system at iiX offers internet access for MVR's from all available states.

Getting Started:

To establish an account, please complete the "End User Agreement" and include a copy of your business license or tax document, then fax to 770.859.0717 or mail to:

e-VERIFILE.COM, Inc.
900 Circle 75 Parkway, Suite 1550
Atlanta, GA 30339

If you have questions, please contact Customer Support at 770.859.9899 Ext: 1.

End User Agreement

Required State Forms if you need MVR Reports from those states: (if applicable)

Employment Form

Insurance Form

Maryland

PUT YOUR ACCOUNT NUMBER, NAME, AND DATE AT THE TOP OF THE DOCUMENT.
Please make sure all blank lines ahead of the signature lines are filled out. Any form not completed will be rejected.
SIGN AND DATE THE SIGNATURE.
HAVE A WITNESS SIGN AND DATE THE DOCUMENT.
THE COMPLETED FORM CAN BE SENT TO e-VERIFILE.COM, Inc. VIA FAX or MAIL:
e-VERIFILE.COM, Inc.
900 Circle 75 Parkway
Suite 1550
Atlanta, GA 30339
Fax: 770-859-0717

New Hampshire

THE FORM FOR THIS STATE MUST BE COPIED ONTO YOUR COMPANY LETTERHEAD.
COMPLETE & SIGN TO RECEIVE NEW HAMPSHIRE DRIVER RECORD INFORMATION.
MAIL COMPLETED FORM TO:
e-VERIFILE.COM, Inc.
900 Circle 75 Parkway
Suite 1550
Atlanta, GA 30339

California

FILL OUT THE ABOVE FORM TO APPLY FOR THE CALIFORNIA REQUESTOR CODE.
BE SURE TO INCLUDE YOUR iiX ACCOUNT #, COMPANY NAME, AND FULL ADDRESS.
To receive California QuickTime MVR's you must have a California Requester Code AND submit the California Online Application to:
Department of Motor Vehicles
Account Processing Unit - H221
P.O. Box 944231
Sacramento, CA 94244-2310
Telephone (916) 657-5564

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Motor Vehicle Subscriber Agreement ** $25.00 Sign up Fee **

Motor Vehicle Subscriber Agreement
$25.00 Sign up Fee