TRAK-1 PRODUCTS & SERVICES

PRICE PER SEARCH

BROADSCREEN PLUS SSN TRAK

BroadScreen Criminal Search

INSTANT!

▪

Multi-State Criminal Search

- Includes available counties in 45 states plus Washington D.C.

Non-covered states currently include Colorado, Delaware, Massachusetts, South Dakota,

West Virginia & Wyoming. Please note that criminal records may be available in these

states through manual state or county searches. Colorado search is available at an

additional charge.

▪

National

Sexual Offender Registry Search - Includes all offenders currently registered with the

National Sex Offender Registry.

▪

For a full list of

features of the BroadScreen Search please visit

https://www.trak-

1.com/coding/forms/other_admin/Broadscreen%20Criminal%20Search%20Coverage%20Specifications.pdf

BROADSCREEN PLUS SSN TRAK

BroadScreen Criminal Search

INSTANT!

▪

Multi-State Criminal Search

- Includes available counties in 45 states plus Washington D.C.

Non-covered states currently include Colorado, Delaware, Massachusetts, South Dakota,

West Virginia & Wyoming. Please note that criminal records may be available in these

states through manual state or county searches. Colorado search is available at an

additional charge.

▪

National

Sexual Offender Registry Search - Includes all offenders currently registered with the

National Sex Offender Registry.

▪

For a full list of

features of the BroadScreen Search please visit

https://www.trak-

1.com/coding/forms/other_admin/Broadscreen%20Criminal%20Search%20Coverage%20Specifications.pdf

SSN Trak

INSTANT! AVAILABLE IN VERSION 2.0 ONLY!

Using the

SSN of your applicant, we provide a history of previous addresses, date of birth, and names

for every

person associated with that SSN.

BROADSCREEN PLUS CREDIT REPORT

BroadScreen Criminal Search

INSTANT!

▪

Multi-State Criminal Search

- Includes available counties in 45 states plus Washington D.C.

Non-covered states currently include Colorado, Delaware, Massachusetts, South Dakota,

West Virginia & Wyoming. Please note that criminal records may be available in these

states through manual state or county searches. Colorado search is available at an

additional charge.

▪

National

Sexual Offender Registry Search - Includes all offenders currently registered with the

National Sex Offender Registry.

▪

For a full list of

features of the BroadScreen Search please visit

https://www.trak-

1.com/coding/forms/other_admin/Broadscreen%20Criminal%20Search%20Coverage%20Specifications.pdf

Employment Credit Reports

INSTANT!

Full credit report from national credit bureau including SSN. This report constitutes a credit

inquiry, and is provided in strict compliance with the FCRA. Its use is restricted to

employment purposes only.

Additional compliance requirements apply to gain access

to credit information. On-site inspection will be required. Additional compliance fee

applies.

$6.50

$11.99

$15.99

(compliance fee for on-

site inspection will apply)

---

BROADSCREEN PLUS CREDIT PLUS MVR

BroadScreen Criminal Search

INSTANT!

▪

Multi-State Criminal Search

- Includes available counties in 45 states plus Washington D.C.

Non-covered states currently include Colorado, Delaware, Massachusetts, South Dakota,

West Virginia & Wyoming. Please note that criminal records may be available in these

states through manual state or county searches. Colorado search is available at an

additional charge.

▪

National

Sexual Offender Registry Search - Includes all offenders currently registered with the

National Sex Offender Registry.

▪

For a full list of

features of the BroadScreen Search please visit

https://www.trak-

1.com/coding/forms/other_admin/Broadscreen%20Criminal%20Search%20Coverage%20Specifications.pdf

Employment Credit Reports

INSTANT!

Full credit report from national credit bureau including SSN. This report constitutes a credit

inquiry, and is provided in strict compliance with the FCRA. Its use is restricted to

employment

purposes only.

Additional access fees may apply.

Motor Vehicle Report (MVR)

48 hour maximum turnaround

MVR reports are instant in most states, but can take up to two days. A faxed copy of the

applicant's consent may be necessary.

Additional state access fees may apply.

MVR

state access fee guide is subject to change and is available upon request.

CUSTOMIZE YOUR OWN SCREENING PACKAGE

Choose any of the following Trak-1 Products and Services to create your own

customized screening

solution for your organization.

BroadScreen Criminal Search

INSTANT!

▪

Multi-State Criminal Search

- Includes available counties in 45 states plus Washington D.C.

Non-covered states currently include Colorado, Delaware, Massachusetts, South Dakota,

West Virginia & Wyoming. Please note that criminal records may be available in these

states through manual state or county searches. Colorado search is available at an

additional charge.

▪

National

Sexual Offender Registry Search - Includes all offenders currently registered with the

National Sex Offender Registry.

▪

For a full list of

features of the BroadScreen Search please visit

https://www.trak-

1.com/coding/forms/other_admin/Broadscreen%20Criminal%20Search%20Coverage%20Specifications.pdf

Please Call for Package

or A 'la Carte Pricing

StateScreen Criminal Search

INSTANT!

▪

Single State Criminal Search

- Includes available counties in one selected state. Colorado

search is available at an additional charge.

▪

National Sexual Offender Registry Search

- Includes all offenders currently registered with

the National Sex Offender Registry.

▪

For a full list

of features of the StateScreen Search visit

https://www.trak-

1.com/coding/forms/other_admin/Broadscreen%20Criminal%20Search%20Coverage%20Specifications.pdf

Please Call for Package

or A 'la Carte Pricing

StateWide Criminal Search

24-72 hour turnaround

▪

Single Statewide Criminal Search

- Includes criminal history information from selected state

operated

repository where available.

Please Call for Package

or A 'la Carte Pricing

County Criminal Record Search

24 - 72 hour turnaround

County-

level criminal searches are the best source for the most recent and up-to-date case

information. A county search will typically disclose the jurisdiction, type of offense, offense

description, case number and case disposition. Many times, a county level search will

disclose city violations, code enforcements and felony traffic offenses where permitted by

law. All Trak-1 county-level criminal searches are FCRA compliant.

Additional state

access fees may apply.

Please Call for Package

or A 'la Carte Pricing

$35.00

(compliance fee for on-

site inspectionwill apply)

---

Federal Court Record Search

24-72 hour turnaround

Federal criminal, civil, or bankruptcy searches can identify otherwise unknown records such

as interstate drug or arms trafficking, identity theft, mail fraud, kidnapping or crimes that

occur on federal

property.

Please Call for Package

or A 'la Carte Pricing

SSN Trak

INSTANT!

AVAILABLE IN VERSION 2.0 ONLY!

Using the

SSN of your applicant, we provide a history of previous addresses, date of birth, and names

for every

person associated with that SSN.

Please Call for Package

or A 'la Carte Pricing

SSN Check

INSTANT!

Using the name, date of birth and SSN of your applicant, we provide up to 3 current and

previous employers and addresses and verify that the SSN provided is a valid and authorized

number by querying the applicant's credit file.

Please Call for Package

or A 'la Carte Pricing

CrimTrak 7 Year 2 County

24-72 hour turnaround

AVAILABLE

IN VERSION 2.0 ONLY!

Using the SSN Trak product, up to 2 county criminal searches are ordered based on last 2

counties of residence in the

past 7 years.

Please Call for Package

or A 'la Carte Pricing

CrimTrak 7 Year 3 County

24-72 hour turnaround

AVAILABLE IN VERSION 2.0 ONLY!

Using the SSN Trak product, up to 3 county criminal searches are ordered based on last 3

counties of residence in the

past 7 years.

Please Call for Package

or A 'la Carte Pricing

CrimTrak 7 Year 4 County Ala Carte

24-72 hour turnaround

AVAILABLE IN VERSION 2.0 ONLY!

Using the SSN Trak product, up to 4 county criminal searches are ordered based on the

most recent counties of residence in the

past 7 years.

Please Call for Package

or A 'la Carte Pricing

CrimTrak 7 Year All County

24-72 hour turnaround

AVAILABLE IN VERSION 2.0 ONLY!

Using the SSN Trak product, unlimited county criminal searches are ordered based on all

counties of residence in the

past 7 years.

Please Call for Package

or A 'la Carte Pricing

Workers Compensation Search

24-72 hour turnaround

Searches

prior workers compensation claims in a selected state. Workers Compensation reports are

not available in all states. State access fees may

apply.

Please Call for Package

or A 'la Carte Pricing

Motor Vehicle Report (MVR)

48 hour maximum turnaround

MVR reports are instant in most states, but can take up to two days. A faxed copy of the

applicant's consent may be necessary.

Additional state access fees may apply.

MVR

state access fee

guide is subject to change and is available upon request.

Please Call for Package

or A 'la Carte Pricing

Commercial Drivers License (CDL) Report

INSTANT!

AVAILABLE IN Version 2.0 ONLY!

Since April

1, 1992, drivers have been required in all 50 states to have a CDL in order to drive a

commercial motor vehicle (CMV). The CDL report provides the current and up to three

previous CDL numbers on an individual commercial driver. The CDL report satisfies DOT

requirements.

Please Call for Package

or A 'la Carte Pricing

Employment Credit Reports

INSTANT!

Full credit report from national credit bureau including SSN. This report constitutes a credit

inquiry, and is provided in strict compliance with the FCRA. Its use is restricted to

employment

purposes only.

Additional access fees may apply.

Please Call for Package

or A 'la Carte Pricing

Nationwide Verifications

Turnaround within 3 days of receipt of completed application*

All

verifications are performed by our in-house team of research analysts and are restricted to

domestic locations only. Up to 5 contact attempts in 3 business days, excluding Holidays.

Additional access fees may apply

. Additional pricing for data entry and customized

questionnaires is available upon request.

Please Call for Package

or A 'la Carte Pricing

Education Verification

– Verifies dates of attendance, areas of study and degrees

obtained.

Please Call for Package

or A 'la Carte Pricing

Employment Verification

– Verifies dates of employment, position, salary, reason for

leaving

and recommendations.

Please Call for Package

or A 'la Carte Pricing

Personal Reference Verification

– Verifies and obtains vital information about

personality, general reputation in the community and overall character.

Please Call for Package

or A 'la Carte Pricing

---

Professional Licensure/Certification/Credentials Verification

– Verifies status and

standing of purported credentials including certifications and professional licensure.

Please Call for Package

or A 'la Carte Pricing

DOT Employment Verifications

24 - 72 hour turnaround NEW IN 2007!

This verification is performed by our in-house team of research analysts and satisfies the

Department of Transportation requirements for employment. In addition to the 5

employment related questions asked in Trak-1's standard nationwide employment

verification, the DOT Employment Verification also provides previous DOT accident/incident

history and previous DOT alcohol/drug test result history.

Additional access fees may

apply

.

Please Call for Package

or A 'la Carte Pricing

WorldWatch

24-48 hour turnaround NEW IN 2007!

Using the name of your applicant, we search 14 federal and international databases for

potential matches among a variety of watch lists, sanctions lists and most wanted lists.

Included searches are OFAC Specially Designated Nationals (SDN) & Blocked Persons,

OFAC Sanctioned Countries, Non-Cooperative Countries & Territories, Department of State

Trade Control Debarred Parties, U.S. Bureau of Industry & Security, (formerly BXA),

Unverified Entities List, Denied Entities List, Denied Persons List, FBI Most Wanted

Terrorists, FBI Top Ten Most Wanted, Interpol Most Wanted List, Bank of England

Sanctions, OSFI Canadian Sanctions List, United Nations Consolidated Sanctions List,

Politically Exposed Persons List, European Union Terrorism List and World Bank Ineligible

Firms.

Please Call for Package

or A 'la Carte Pricing

Employment Eligibility Verification

24-48 hour turnaround for initial inquiries

Verifies a

newly hired employee's eligibility to work within the United States by checking the employee's

name and Social Security Number against federal databases. The purpose of this search is

to flag the use of counterfeit green cards and Social Security Numbers. The verification can

only be performed POST-HIRE and must be performed within 3 days of the start date.

Please Call for Package

or A 'la Carte Pricing

Lab-Based Drug Testing

24-72 hour turnaround NEW IN 2007!

A sample is collected at a Trak-1 affiliated collection site, and the sample is processed by a

Trak-1 affiliated testing laboratory. The specimen is examined by the laboratory for the

presence of drugs. The testing consists of an initial screen, and confirmation tests, when the

screen indicates the presence of one or more substances.

See Instant Device Pricing

Addendum.

Please Call for Package

or A 'la Carte Pricing

▪

Non-regulated

Urine Testing. Typically 5 through 9 panel with anything more than 9 drugs.

Please specify which additional drugs are needed. MRO not required but generally utilized.

Certain state laws affect testing not regulated under DOT.

Please Call for Package

or A 'la Carte Pricing

▪

DOT regulated Urine Testing

5 panel includes random drug and alcohol, post accident

and reasonable suspicion testing. MRO required. Must be conducted in a SAMHSA certified

laboratory.

Please Call for Package

or A 'la Carte Pricing

▪

Hair Testing

Strands of hair are collected at a collection facility and then shipped to a

laboratory for testing. The detection window is much greater with hair testing. A back-up

plan needs to be considered when hair is unavailable.

Please Call for Package

or A 'la Carte Pricing

Instant Device Drug Testing

5-10 panel cup :

Disposable cup used to collect specimen. Testing strips are attached to

cup providing results in approximately 5 minutes. Complete instructions for use are included

with all devices. Lab confirmation is suggested on all potential non-negative results.

Shipping material included with all devices.

Instant oral device

: A specimen is collected using a swab which is then sent to a laboratory

for analysis. Most companies performing saliva testing will collect on-site and ship to the

laboratory. By doing this, third party collection costs are saved.

Alcohol saliva strips

: A reactive pad that is placed in the mouth and provides results in a

matter of seconds. Instructions for use are included with all orders. Detects alcohol levels

ranging from 0.2 to 0.8

Please Call for Package

or A 'la Carte Pricing

▪

Confirmation

. A secondary test performed on a specimen to identify and quantify the

presence of a specific drug or drug metabolite. The results of the confirmation test are then

transmitted to the MRO.

Please Call for Package

or A 'la Carte Pricing

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Breath Alcohol Test.

24-72 hour turnaround.

A

breath alcohol test is an estimate of your blood alcohol concentration (BAC). The test

measures the amount of alcohol in the air that you breathe out (exhale). In accordance with

DOT rule, 49 CFR Part 40, two tests are required to determine if a person has a prohibited

alcohol concentration. A screening test is conducted first. Any result less than 0.02 alcohol

concentration is considered a "negative" test. If the alcohol concentration is 0.02 or greater, a

second confirmation test must be conducted. Can be conducted lab-based or on-site.

Please Call for Package

or A 'la Carte Pricing

Pre-Adverse Action Services

24 hour turnaround

Trak-1 will issue to each applicant submitted by Customer into the Trak-1 system, a

standardized form letter, copy of report and Federal Trade Commission approved notice of

rights that has been developed for the purpose of satisfying the Customer’s pre-adverse

action obligations set forth in the Fair Credit Reporting Act.

IT WILL BE THE SOLE

OBLIGATION OF CUSTOMER TO SUBMIT A CURRENT KNOWN ADDRESS INTO THE

TRAK-1 SYSTEM FOR EACH OF CUSTOMER’S PRE-EMPLOYMENT APPLICANTS.

CUSTOMER FULLY UNDERSTANDS AND ACKNOWLEDGES THAT TRAK-1 WILL

SEND ANY ADVERSE ACTION RELATED NOTICES AND INFORMATION TO SUCH

ADDRESS AS IT IS PROVIDED BY CUSTOMER.

Please Call for Package

or A 'la Carte Pricing

Post-Adverse Action Services

24 hour turnaround

In the event that Customer elects to deny initial employment, deny a promotion, withdraw

continued employment or otherwise take an adverse action against an applicant (whether

pre-employment or an existing employee of Customer) as a result of a Report provided by

Trak-1 to Customer, Customer may direct Trak-1 to issue a post-adverse action letter to

such applicant. Such notice will only be provided by Trak-1 in the event that a pre-adverse

action notice has already been sent by Trak-1 to such Customer. Additionally, Trak-1 will

transmit such notice to the same address submitted into the Trak-1 system by Customer.

IT

WILL BE THE SOLE OBLIGATION OF CUSTOMER TO SUBMIT A CURRENT KNOWN

ADDRESS INTO THE TRAK-1 SYSTEM FOR EACH OF CUSTOMER’S PRE-

EMPLOYMENT

APPLICANTS.

CUSTOMER

FULLY

UNDERSTANDS

AND

ACKNOWLEDGES THAT TRAK-1 WILL SEND ANY ADVERSE ACTION RELATED

NOTICES AND INFORMATION TO SUCH ADDRESS AS IT IS PROVIDED BY

CUSTOMER

Please Call for Package

or A 'la Carte Pricing

Employment Adjudication

24-48 Hour Turnaround Time

AVAILABLE IN VERSION 1.0!

COMING SOON TO VERSION 2.0!

Using hiring criteria provided to Trak-1 by Customer (ie a hiring matrix, minimum hiring

requirements, etc.), Trak-1 personnel will review each Trak-1 report and return a pre-defined

customer decision based on the information returned in the Trak-1 report. If the Customer's

hiring criteria would accept the applicant based on the results returned in the Trak-1 report,

Trak-1 will return a "GO" result to the customer. If the Customer's hiring criteria indicate that

the applicant is NOT eligible for hire by Customer due to information contained in the

applicant's report, then Trak-1 will return a "STOP" decision on the application. In some

cases, a judgment call will be required to determine whether or not an applicant is eligible for

hire (ie if the hiring criteria are unclear, if the results returned present a question requiring

interpretation, etc.) in which case Trak-1 will return a "NEEDS ATTENTION" to the

Customer to ensure Customer's review of the application

and hiring decision are timely made

Please Call for Package

or A 'la Carte Pricing

On-Site Inspection Fee:

$75 - $95.00

Your Church must undergo an on-site inspection before being allowed to access credit data.

This process is usually completed within a few days.

Charge appears on first monthly

invoice.

Administrative Client Set-up

Fee

$0.00

One time fee allows Trak-1 Representative to provide you with the lowest possible pricing by

covering up front certain set costs including account set up and implementation, compliance

and vetting, creation and issuance of the username and password and initial an ongoing

training and support.

Waived

Annual Maintenance Fee

$0.00

Helps Trak-1 continue to make available the high speed connections that allow our data

providers to return results rapidly

Waived

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CUSTOMER COMPLIANCE PACKAGE

CONSUMER CREDIT REPORTS

1. Application to Access Credit Data

Customer Returns Complete

2. Trak-1 FCRA Agreement

Customer Returns Complete

3. On-Site Inspection Certification

*Trak-1 Representative Completes

4. Vermont FCRA Certification

For Customer Records

5. Canadian Provincial Legislative Overview

For Customer Records

*Customer to review Physical On-Site Inspection Form and contact Trak-1 Representative to arrange a

date and time for Trak-1, or a Trak-1 third-party representative, to perform and complete the Physical

On-Site Inspection.

PROVIDED TO CUSTOMERS WHO REQUEST CONSUMER CREDIT REPORTS

---

2705 East 21

st

Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 2 of 9

Volume 2 – Updated 12/4/06

APPLICATION TO ACCESS CREDIT DATA

Anyone who is given access to credit data is placed under stringent legal obligations that are spelled out in the Fair Credit Reporting Act (FCRA), as amended by the Fair and

Accurate Transactions Act (FACTA). Additionally, each of the 50 states has their own separate state laws which regulate the receipt and use of credit data information.

Accordingly, in order for Trak-1 to grant access to consumer credit data, Customer must complete and sign this Application, providing full and accurate information.

GENERAL CUSTOMER CONTACT INFORMATION

____________________________________________________________________________________

Customer Billing Name

____________________________________________________________________________________

Customer Billing Address (Street, City, State, Zip)

____________________________________________________________________________________

Customer Telephone Number(s)

____________________________________________________________________________________

Customer Fax Number(s)

____________________________________________________________________________________

Primary Contact Name and Title

____________________________________________________________________________________

Name of Person Completing the Form and Title

CUSTOMER INFORMATION

Fully document responses in the space provided or on additional referenced pages.

Item #1:

What is the legal name of the customer when conducting business (i.e. the legal name of the corporation or other

business entity that will be using the services of Trak-1)?

_____________________________________________________________________________________________

Item #2:

Please provide all business and/or trade names used by the above legal entity?

_____________________________________________________________________________________________

(Please specify)

Item #3:

What is the IRS classification of the above legal entity? ______________________________________

(i.e., sole proprietor, partnership, corporation)

Item #4:

If a sole proprietor or partnership, please provide the following for each individual:

________________________________________

________________________________________

Name

Name

________________________________________

________________________________________

Home Address (street address only, no PO Box)

Name (street address only, no PO Box)

________________________________________

________________________________________

City, State, Zip

City, State, Zip

________________________________________

________________________________________

SSN or other TIN

SSN or other TIN

Item #5:

For what purpose(s) will Customer use the credit data it receives from Trak-1? (check all that apply)

?

Resident Screening

?

Employment Purposes

?

Insurance Underwriting

?

Credit Extension

?

Other: _______________________________________________________________________________

(Please specify)

Item #6:

Will any other business entity have access to Trak-1 Service information?

?

YES (please provide information in Items 1-5 for each such business entity)

?

NO

---

2705 East 21

st

Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 3 of 9

Volume 2 – Updated 12/4/06

Item #7:

Please list all business activities of Customer:

Is the customer involved either directly or indirectly, or engaged in the business of any of the following:

?

Adult entertainment

?

Law firm engaged in practice of law (unless engaged in collection or using the report in connection with a consumer bankruptcy)

?

Bail bondsman (unless licensed by the state in which they are operating)

?

Credit counseling (except not-for-profit credit counselors)

?

Credit repair clinic

?

Dating service

?

Financial counseling (except a registered securities broker dealer)

?

Genealogical or heir research firm

?

Massage service

?

Company that locates missing children

?

Pawn shop

?

Private detective, detective agency or investigative company

?

Company that handles third party repossessions

?

Subscriptions (magazines, book clubs, record clubs, etc.)

?

Tattoo service

?

Company seeking information in connection with time shares (exception: financers of time shares)

?

Law enforcement agency

?

News agency or journalist

?

Other resellers (in some cases)

Item #8:

Has Customer used a credit reporting agency, other than Trak-1, within the last 12 months for the purpose indicated in

Item #5?

?

YES, please provide the name:

?

NO

Item #9

:

a.

If Customer intends to use Trak-1 for employment purposes, does Customer have and utilize a “consumer disclosure

and authorization”, “pre-adverse action” and “adverse action” forms as required by the FCRA?

?

YES (please attach samples of each)

?

NO (please ask your Trak-1 account representative to send samples to you)

b.

If Customer intends to use Trak-1 for residential purposes, does Customer have and utilize a “consumer disclosure

and authorization” and “adverse action” form as required by the FCRA?

?

YES (please attach samples of each)

?

NO (please ask your Trak-1 account representative to send samples to you)

Item #10:

Has the customer read in full and signed the Trak-1 Services Agreement and the accompanying Trak-1 Customer

Compliance and Credit Addendum, including the accompanying Summary of Rights of Consumers and Obligations of End

Users?

?

YES

?

NO

Item #11:

Has the customer undergone a physical on-site inspection at their place of business by a Trak-1 representative?

?

YES (please provide name of representative and date:

?

NO (please contact your Trak-1 account representative to schedule this)

The undersigned represents that they have completed the above with full and accurate information and that they

are fully authorized to provide the same.

____________________________________________________________________________________

Signature

Date

____________________________________________________________________________________

Printed Name

Title

---

2705 East 21

st

Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 4 of 9

Volume 2 – Updated 12/4/06

TRAK-1 Fair Credit Reporting Act Agreement

Trackers, Inc. d/b/a Trak-1 Technology (“TRAK-1”) will only provide (resell) consumer credit information or reports to the Customer upon the condition

the request is in compliance with the Fair Credit Reporting Act (FCRA). The following are legitimate reasons for requesting credit information:

1.

In connection with the extension of credit to, or review or collection of an account from, the consumer on whom the information is requested; or

2.

For legitimate employment purposes; or

3.

In connection with the underwriting of insurance involving the consumer; or

4.

In connection with a valuation of, or an assessment of the credit or prepayment risks associated with, an existing credit obligation (Customer

must be a potential investor in or services of, or a. current insurer of an existing credit obligation); or

5.

In connection with a business transaction involving the consumer where the user has a legitimate business need for the information.

The Customer shall not obtain consumer credit information (‘credit reports”) made available through this Agreement for any purposes not permissible as

defined in the FCRA. The Customer agrees to use the information they are requesting and obtaining credit reports only for one of the five purposes

stated above, and for no other purpose. The Customer agrees to comply with any state or local laws governing the disclosure of consumer credit

information.

The Customer agrees the requested information is for their exclusive use only, and to keep all information received in strict confidence except as

required by law. The Customer may, however, provide the subject of the report with a copy of the report or otherwise disclose the contents of the report

to the subject. The Customer may not attempt to obtain reports on themselves, associates, or others except in the exercise of their official duties for the

permissible purposes allowed under this Agreement.

THE CUSTOMER RELEASES AND INDEMNIFIES TRAK-1, AND THE CONSUMER CREDIT INFORMATION PROVIDER, AS WELL AS THEIR

OFFICERS, EMPLOYEES, CONTRACTORS, AND AGENTS FROM ALL LIABLITY ARISING FROM (1) THE CUSTOMERS ACCESS TO OR

DISCLOSURE OF INFORMATION UNDER THIS AGREEMENT; (2) THE CUSTOMERS USE OR RELIANCE OR CONSUMER CREDIT

INFORMATION; AND (3) ANY VIOLATIONS OF THE FCRA OR OTHER APPLICABLE LAWS DUE TO THE ACTS OR OMISSIONS OF THE

CUSTOMER.

The Customer will indemnify, defend and hold harmless TRAK-1, and The Consumer Credit Information Provider from all liability, costs, claims,

expenses, demands and fees, including reasonable attorney’s fees, arising out of the Customers’ use of the information provided under this Agreement.

Customer agrees that it has received and is in compliance with the Fair Credit Reporting Act, Vermont Fair Credit

Reporting Act Certification New Jersey Identity Theft Prevention Act and Certification and the Canadian Provincial

Legislative Overview (see attached).

______________________________________

Company Name

______________________________________

Signature

Title

___________________________________

Print Name/Title

______________________________________

Date

---

2705 East 21

st

Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 5 of 9

Volume 2 – Updated 12/4/06

ON-SITE INSPECTION FORM

Anyone who is given access to credit data is placed under stringent legal obligations that are spelled out in the Fair Credit Reporting Act (FCRA), as

amended by the Fair and Accurate Transactions Act (FACTA). Additionally, each of the 50 states has their own separate state laws which regulate the

receipt and use of credit data information. Accordingly, in order for Trak-1 to grant access to consumer credit data, Customer must undergo a complete

physical, on-site inspection by an authorized Trak-1 Technology employee and/or agent.

CUSTOMER CONTACT INFORMATION AND INTERVIEW DETAILS

Customer Name and Address (Street, City, State, Zip)

Customer Telephone Number(s)

Person Interviewed

Title of Person Interviewed AND Business Relationship to Customer

Location of Interview (if different from above-referenced customer address)

INTERVIEW QUESTIONNAIRE

Fully document each Customer response in the space provided or on additional referenced pages.

Item #1:

Is the person being interviewed an owner, employee or agent of the business entity referenced above?

?

YES

?

NO (if NO, please explain) ___________________________________________________________________

Item #2:

What is the nature of the customer’s business?

_

(Please specify)

Item #3:

List all business entities affiliated with the Customer that will be given access to the Trak-1 Service:

___________________________________________________________________________________

___________________________________________________________________________________

Item #4:

Provide a list of physical street addresses for all locations that will be given access to the Trak-1 Service and/or the credit

reports provided by Trak-1: (refer to those affiliates listed in Item #2)

__________________________________________

________________________________________

Street, City, State, Zip

Street, City, State, Zip

__________________________________________

________________________________________

Street, City, State, Zip

Street, City, State, Zip

__________________________________________

________________________________________

Street, City, State, Zip

Street, City, State, Zip

Item #5:

Please provide all website address(es)/URLs for Customer’s business AND attach copies of the home pages for each

website address listed:

____________________________________________________________________________________

____________________________________________________________________________________

Item #6:

Will any other business entity have access to Trak-1 Service information?

?

YES (please provide information in Items 1 through 4 for each such business entity)

?

NO

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2705 East 21

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Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 6 of 9

Volume 2 – Updated 12/4/06

Item #7:

Provide a list of all individual employees of the Customer (including the title and department of each employee) who will

be authorized to use the Trak-1 Service:

___________________

________________________________________________________________________________________________

Item #8:

a.

Describe the general location where Trak-1 Services will be used (e.g., enclosed private office, behind public counter,

open general office, etc.).

b.

If Trak-1 Services will be used in an open general office environment or behind a public counter, has Customer

implemented a written policy and procedure designed to protect and restrict direct and indirect unauthorized access to

sensitive consumer information? (please attach copies of said procedure)

a.

____________________________________________________________________________________________

b.

____________________________________________________________________________________________

Item #9:

Will unauthorized employees have access to the location where the Trak-1 Service is to be used?

?

YES (if YES, provide details)

?

NO

Item #10:

Is any other business activity conducted on the premises where the Trak-1 Service is to be used?

?

YES (if YES, provide details)

?

NO

POST-INTERVIEW ASSESSMENT

Interviewer: fill out the following section upon completion of the interview with the Customer.

?

YES

?

NO Was the interview conducted in the location where the Trak-1 Service is

to be provided? (If NO, provide details)

?

YES

?

NO Is the site where the Trak-1 Service is to be used located in a commercial building? (If NO, provide

details)

?

YES

?

NO

Is there a sign on the exterior of the business identifying the customer?

?

YES

?

NO Are there signs or advertisements in the customer’s office that are compatible with the purported business

the customer indicated?

?

YES

?

NO

Are the furnishings of a professional nature and commensurate with the size and purported nature of the

business?

?

YES

?

NO

Does the customer appear in the Yellow Pages or Business Section of the phone book? (If YES, indicate

section: ______________________________)

(If NO, can business be verified with information? [ YES ] [ NO ] )

?

YES

?

NO

Do any of the business names provided by the Customer appear under a section of the Yellow

Pages

that would indicate a relationship with a prohibited business type? (If YES, indicate business name and section:

____________________________ )

?

YES

?

NO

Does the company share office space with another firm?

Name of other firm(s): ___________________________________________________

Affiliation (if any): _______________________________________________________

?

YES

?

NO

Is there any evidence indicating that the company or any adjacent business is involved or

associated with an unauthorized business type?

How many full time employees were on the premises at the time of the interview?___________

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Page 7 of 9

Volume 2 – Updated 12/4/06

Interviewer Verification:

The undersigned represents that they have completed the above with Customer and/or Customer’s

employee/agent, at Customer’s business location.

____________________________________________________________________________________

Signature

Date

____________________________________________________________________________________

Printed Name

Title

Interviewee Verification:

The undersigned represents that they have completed the above with the above-referenced Interviewer, and has

provided said Interviewer with complete and accurate information.

____________________________________________________________________________________

Signature

Date

____________________________________________________________________________________

Printed Name

Title

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2705 East 21

st

Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 8 of 9

Volume 2 – Updated 12/4/06

VERMONT FAIR CREDIT REPORTING CERTIFICATION

The customer (“Customer”), acknowledges that it subscribes to receive various information services from Trackers Inc., d/b/a Trak-1 Technology

(‘TRAK-1’). To the extent that customer now or sometime in the future may subscribe to receive credit reports on Vermont residents, customer services

that it will do so in accordance with the Vermont Fair Credit Reporting Statute, 9 VSA § 2480e (1999), as amended (the “VFCRA”) and the Federal Fair

Credit Reporting Act, 15 U.S.C. § 1681 et seq., as amended (the “FCRA”) and its other state law counterparts. In connection with Customer’s use of

TRAK- information services in relation to Vermont residents, Customer hereby certifies as follows:

Vermont Certification. Customer certifies that it will comply with applicable provisions under Vermont law. In particular, Customer certifies that it will

order information services relating to Vermont residents, that are credit reports as defined by the VFCRA, only after Customer has received prior

consumer consent in accordance with VFCRA § 2480e and applicable Vermont Rules. Customer further certifies that the attached copy of VFCRA §

2480e and applicable Vermont Rules were received by Customer from TRAK-1.

Vermont Fair Credit Reporting Statute, 9 V.S.A. § 2480e (1999)

§ 2480e. Consumer consent

(a) A person will not obtain the credit report of a consumer unless:

(1) the report is obtained in response to the order of a court having jurisdiction to issue such an order; or

(2) the person has secured the consent of the consumer, and the report is used for the purpose consented to by the consumer.

(b) Credit reporting agencies will adopt reasonable procedures to assure maximum possible compliance with subsection (a) of this section.

(c) Nothing in this section will be construed to affect:

(1) the ability of a person who has secured the consent of the consumer pursuant to subdivision (a)(2) of this section to include in

his or her request to the consumer permission to also obtain credit reports, in connection with the same transaction or extension of credit, for the

purpose of reviewing the account, increasing the credit line on the account, for the purpose of taking collection action on the account, or for other

legitimate purposes associated with the account; and

(2) the use of credit information for the purpose of prescreening, as defined and permitted from time to time by the Federal Trade

Commission.

VERMONT RULES *** CURRENT THROUGH JUNE 1999 ***

AGENCY 06. OFFICE OF THE ATTORNEY GENERAL

SUB-AGENCY 031. CONSUMER PROTECTION DIVISION

CHAPTER 012. Consumer Fraud--Fair Credit Reporting

RULE CF 111 FAIR CREDIT REPORTING

CVR 06-031-012, CF 112.03 (1999)

CF 112.03 CONSUMER CONSENT

(a) A person required to obtain consumer consent pursuant to 9 V.S.A. § § 2480e and 2480g will obtain said consent in writing if the

consumer has made a written application or written request for credit, insurance, employment, housing or governmental benefit. If the consumer has

applied for or requested credit, insurance, employment, housing or governmental benefit in a manner other than in writing, then the person required to

obtain consumer consent pursuant to 9 V.S.A. § 7480e and 2480g will obtain said consent in writing or in the same manner in which the consumer made

the application or request. The terms of this rule apply whether the consumer or the person required to obtain consumer consent initiates the transaction.

(b) Consumer consent required pursuant to 9 V.S.A. § 2480e and 2480g will be deemed to have been obtained in writing if, after a

clear and adequate written disclosure of the circumstances under which a credit report or credit reports may be obtained and the purposes for which the

credit report or credit reports may be obtained, the consumer indicates his or her consent by providing his or her signature.

---

2705 East 21

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Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 9 of 9

Volume 2 – Updated 12/4/06

CANADIAN PROVINCIAL LEGISLATIVE OVERVIEW

Canada does not have a federal statute regulating credit reporting.

Instead, credit reporting regulation is provided under provincial law in

the provinces of British Columbia, Saskatchewan, Manitoba, Ontario,

Quebec, Nova Scotia, Prince Edward Island and Newfoundland. Not all

the laws are the same, particularly regarding the rules about purging

obsolete information. Additionally, some of the provincial laws require

notification to the consumer when a credit report is requested (see

below), but all do require post-notification regarding adverse action.

Canada has no similar law to the Equal Credit Opportunity Act (“ECOA”)

or the Fair Credit Reporting Act (“FCRA”). Therefore, Canadian reports

differ from US reports in that no ECOA and/or FCRA designation is

listed.

All of the above named provinces, with the exception of Saskatchewan,

require some form of notification to consumers that a credit report will

be or has been accessed on them.

Although you will want to

independently review all relevant statutes, some brief synopses of the

provincial credit reporting laws follows.

British Columbia

No person shall obtain from a reporting agency a report…(a) without the

express written consent of the consumer, or (b) unless he/she promptly

notifies the consumer in writing that a consumer report will be obtained.

(The consent may be contained in an application for credit, insurance,

employment or tenancy, if it is clearly set forth in type not less than 10

point in size, above the signature of the consumer.)

Saskatchewan

No pre-notification requirement, but does require post-notification.

Manitoba

No person shall conduct, or cause to be conducted, a personal

Investigation (a) without the express written consent of the subject, or

(b) unless the subject is given written notice by the user, within ten days

of the granting or denial of the benefit for which the subject has applied,

that a personal investigation was conducted.

This consent may be contained in an application for credit, insurance,

employment or tenancy if clearly set forth in type not less than 10 point

size above the subject’s signature, and the consent shall be deemed to

be continuing during the term of any agreement for credit, insurance,

employment or tenancy; but, if the user refuses any application for

Increase of any benefits under any such agreement the user shall give

notice of any partial or complete denial of such application as required

under law.

Ontario

Where a person proposes to extend credit to a consumer, and a

consumer report containing credit information only is being or may be

referred to in connection with the transaction, he/she shall give notice of

the fact to the consumer in writing at the time of the application for

credit; or, if the application is made orally, orally at the time of the credit

application.

Quebec

Since January 1, 1994, the Act Respecting the Protection of

Personal Information in the Private Sector imposes various

obligations upon companies which conduct business in Quebec

with regard to collecting, using and communicating personal

information, including credit information.

Moreover, this Act

prohibits any company from sending credit information held in

Quebec about persons residing in Quebec to third persons without

consent from the persons concerned or in circumstances set forth

in the Act. Therefore, before obtaining any credit information from

the Trackers, Inc. d/b/a Trak-1 Technology concerning a person

residing in Quebec, the member must obtain the specific consent

of the consumer or be able to prove that one of the exceptions set

forth in the Act applies (Sections 18 and 23). The member must

also use this information only for the specific purpose consented to

by the consumer or as otherwise authorized by the Act.

Nova Scotia

No person shall procure or cause to be prepared a consumer

report…(a) without the express written consent of the consumer, or

(b) unless he/she notifies the consumer in writing that a consumer

report has been or will be requested, and advises him/her not later

than ten days after the report has been requested of the consumer

reporting agency’s name and address. This notice and consent

may be contained In an application for credit, insurance,

employment or tenancy if clearly set forth In type not less than 10

point in size above the signature of the consumer.

Prince Edward Island

No person shall procure from the consumer reporting agency, or

cause it to prepare, a consumer report...unless he/she notifies the

consumer of that fact before the report is requested, or he/she has

already obtained the consumers consent.

Newfoundland

Requires notification for reports containing “personal” information

(investigative consumer reports), which would not include credit

reports. However, the Act provides that, where the credit risk of a

consumer is being assessed by any person, that person shall,

upon request of the consumer, inform the consumer if a credit

report has been obtained and of the name of the consumer

reporting agency supplying the report.

Please be aware that this information is provided for

information purposes only and is not intended to be, nor

should it be used or construed as, legal advice.

---

CUSTOMER COMPLIANCE PACKAGE

MOTOR VEHICLE RECORDS

1. Addendum for Motor Vehicle Records

Customer Returns Complete

2. Customer Information Form

Customer Returns Complete

3. Pennsylvania Authorization Form

For Customer Records

4. Washington Authorization Form

For Customer Records

PROVIDED TO CUSTOMERS WHO REQUEST MOTOR VEHICLE RECORDS

---

ADDENDUM TO CUSTOMER SERVICES AGREEMENT

MOTOR VEHICLE RECORDS ADDENDUM

2705 East 21

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Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 2 of 5

Volume 2 – Updated 12/4/06

This Addendum is executed by and between Trackers Inc. d/b/a Trak-1 Technology (“TRAK-1”) and

__________________________ (“Customer”) and is entered into this ____ day of _______________, 20___.

I.

EFFECT of ADDENDUM.

This Addendum is entered into only with Client who has executed an underlying Customer Services

Agreement (“CSA”) by and between TRAK-1 and Customer. This Addendum merely supplements the existing CSA between

Customer and TRAK-1 and does not amend, modify or delete any existing terms therein including terms of payment or other

terms and conditions contained in the underlying CSA. This Addendum shall be interpreted together with the CSA to form one

exclusive Agreement.

II. SERVICES.

During the term of the CSA, Customer shall use the services of TRAK-1. TRAK-1 will be responsible for the

provision of products and services enumerated in Customer’s Pricing Addendum.

III. CHARGES for SERVICES.

A current list of TRAK-1’s prices offered to Customer for services provided by TRAK-1 to Customer

will be in accordance with the Pricing Addendum. Prices to the Pricing Addendum may be change from time to time at the sole

discretion of TRAK-1. TRAK-1 shall provide a thirty (30) day written notice of price increases to be sent to Customer. Applicable

sales and/or other taxes shall be added to all fees. If during the term of the Agreement, a significant change in the requirements

of TRAK-1, or other services covered under this Addendum, occurs as a result of regulatory changes, or other changes mandated

by federal or state law, both TRAK-1 and Customer agree to renegotiate the services and fees provided herein, subject to

severability provisions described elsewhere within the CSA.

IV. LEGITIMACY OF BUSINESS

. In compliance with applicable statutory requirements, TRAK-1 verifies the legitimacy of all

Customers who request Motor Vehicle Records. In order to expedite the policy process, Customer is required to provide the

information in its entirety in the Customer Information Form, herein incorporated into this Addendum. Customer is advised that

failure to provide complete and accurate information may result in a delay of TRAK-1 services. Should any of the information

provided be modified or changed, Customer must promptly notify TRAK-1 in writing of such modification or change. Failure to do

so may result in immediate termination of TRAK-1 services.

V. MISCELLANEOUS PROVISIONS.

a. In no event shall TRAK-1 have any responsibility or liability to Customer for any failure or delay in performance by TRAK-1

which results from or is due to, directly or indirectly and in whole or in part, any cause or circumstances beyond the

reasonable control of TRAK-1.

b. The parties both recognize that federal, state and local laws may apply to the services covered herein. In particular certain

services may be performed according to regulations established and governed by the Driver Privacy Protection Act. Both

parties agree to assure that services provided are rendered according to all applicable laws and regulations.

_________________________________________________

Company Name

Date

_________________________________________________

Signature

_____________________________________________

Print Name

Title

---

ADDENDUM TO CUSTOMER SERVICES AGREEMENT

MOTOR VEHICLE RECORDS ADDENDUM

2705 East 21

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Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 3 of 5

Volume 2 – Updated 12/4/06

CUSTOMER INFORMATION FORM

MOTOR VEHICLE RECORDS

Customer has a permissible purpose for obtaining consumer reports in accordance with the Fair Credit Reporting Act, 15 U.S.C. § 1681

et seq., including, without limitation, all amendments thereto (“FCRA”). Customer represents that in addition to complying with the

FCRA, it will follow the obligations under the Driver Privacy Protection Act, 18 U.S.C. § 2721 et seq., (“DPPA”) and other similar federal,

state and local laws regulating the release of such consumer reports. Customer certifies that it will follow the requirements of the DPPA

and the various state laws implementing the DPPA in regard to motor vehicle reports.

PART I. TYPE OF BUSINESS

(please select and initial)

_____

Employer*.

Screening applicants and/or employees for Customer’s company only.

Number of Employees: _____

Describe Type of Business: _________________________________________________

*

All Non-Motor Carrier Companies must provide one of the following documents completed by the IRS

(please select & provide verification to your Trak-1 Representative):

EFTPS Enrollment Form

Federal 940 FUTA Return

Federal Tax Deposit Coupon

Federal 941 Quarterly Return

_____

Motor Carrier

. Customer must provide DOT, ICC or Public Utility Commission (PUC) number: ________________________

Customer is a member of a State Trucking Association:

NO

YES

If Yes, Customer is a member of the following State(s) Trucking Association: _______________________________________

_____

Insurance Agency or Company

.

Customer must provide one of the following:

Copy of Producer/Agency License OR

NAICS Code (Provide Certificate of Authority): _________________________

_____

Reseller (Wholesale).

Please indicate your client base:

Employers

Insurance Companies

Other: _____________________________

PART II. CONSUMER CREDIT REPORTS

Will Customer be ordering Consumer Credit Reports?

YES*

No

*If Yes, Customer must also receive and complete the Consumer Credit Reports Addendum.

PART III. MVR PRODUCT ACCESS

Will Customer be ordering Motor Vehicle Reports (MVR)?

YES*

No

*If Yes, Customer must indicate the purpose for ordering MVR. Please note that additional State Specific Paperwork may be required.

Customer orders MVRs for employment purposes, i.e. for applicants and employees only

Customer orders MVRs for the purpose of underwriting insurance.

Customer orders MVRs for the purpose of reselling or providing to a third party (please identify reason below):

Insurance

Employment

Other: ______________________________________________________________

Customer orders MVRs for another reason. Please describe: ___________________________________________________

____________________________________________________________________________________________________

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ADDENDUM TO CUSTOMER SERVICES AGREEMENT

MOTOR VEHICLE RECORDS ADDENDUM

2705 East 21

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Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 4 of 5

Volume 2 – Updated 12/4/06

State of Pennsylvania Driver Authorization

I, ___________________________________, do hereby authorize the Division of Motor Vehicles to

release my driving record to.

End User Company Name: __________________________________________________________

Address: ________________________________________________________________________

________________________________________________________________________________

Phone Number: ___________________________________________________________________

This release shall remain in full force and effect until I, myself, file formal withdrawal.

Driver’s Full Name ________________________________________________________________

Date of Birth ______________________________________________________________________

Drivers License Number ___________________________________________________________

_______________________________________

Signature

_______________________________________

Date

---

ADDENDUM TO CUSTOMER SERVICES AGREEMENT

MOTOR VEHICLE RECORDS ADDENDUM

2705 East 21

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Street – Tulsa, Oklahoma 74114 – Ph. (918) 779-7000 – www.trak-1.com

Page 5 of 5

Volume 2 – Updated 12/4/06

State of Washington Driver Authorization

EMPLOYEE OR PROSPECTIVE EMPLOYEE REQUEST

That I, _________________________________, am an employee or prospective employee of the company

named below and that I request a copy of my official Driving Record in the

State of Washington

be released

to my employer or prospective employer or their agent.

Authorization of employee or prospective employee for release of abstract of driving record

_________________________________________________________________________________________________

Signature

Date

WA License #

or print full name & date of birth

EMPLOYER ATTESTATION

(A) That the company named below is an employer or prospective employer of the above named individual and that I am a

representative authorized to bind said company.

(B) That

Trak-1 Technology

is acting as agent on our behalf to obtain the abstract of driver records of the above named individual.

(C) That abstracts of driver record

shall be used exclusively to determine whether the above named individual should be

employed to operate a school bus or commercial vehicle upon the public highways

, and that no information contained therein

shall be divulged, sold, assigned, or otherwise transferred to any third person or party. A commercial vehicle is defined as any vehicle

the principal use of which is the transportation of commodities, merchandise, produce, freight, animals, or passengers for hire.

(D) That the information contained in the abstracts of driver records obtained from the

Washington State Department of Licensing

shall be used in accordance with the requirements and in no way violate the provisions of RCW 46.52.130, attached in part for easy

reference.

___________________________________

Company Name

______________________________________

Address

______________________________________

Name (print)

Title

______________________________________

Signature

Date

This record must be maintained by the employer or prospective employer for a period of not less than two (2) years from the

last date above. Failure to obtain all signatures or misuse of records obtained from the State of Washington may result in

prosecution under RCW 46.52.130.

RCW 46.52.130 Abstract of driving record -- Access -- Fees -- Penalty

A certified abstract of the driving record shall be furnished only to the individual named in the abstract, an employer or prospective employer or an agent

acting on behalf of an employer or prospective employer. Upon proper request, a certified abstract of the full driving record maintained by the

department shall be furnished to the individual named in the abstract or to an employer or prospective employer or an agent acting on behalf of an

employer or prospective employer of the named individual. The abstract, whenever possible, shall include an enumeration of motor vehicle accidents in

which the person was driving; the total number of vehicles involved; whether the vehicles were legally parked or moving; whether the vehicles were

occupied at the time of the accident; whether the accident resulted in any fatality; any reported convictions, forfeitures of bail, or findings that an

infraction was committed based upon a violation of any motor vehicle law; and the status of the person's driving privilege in this state. The enumeration

shall include any reports of failure to appear in response to a traffic citation or failure to respond to a notice of infraction served upon the named

individual by an arresting officer. Any employer or prospective employer or an agent acting on behalf of an employer or prospective employer receiving

the certified abstract shall use it exclusively for his or her own purpose to determine whether the licensee should be permitted to operate a commercial

vehicle or school bus upon the public highways of this state and shall not divulge any information contained in it to a third party. Release of a certified

abstract of the driving record of an employee or prospective employee requires a statement signed by: (1) The employee or prospective employee that

authorizes the release of the record, and (2) the employer attesting that the information is necessary to determine whether the licensee should be

employed to operate a commercial vehicle or school bus upon the public highways of this state. If the employer or prospective employer authorizes an

agent to obtain this information on their behalf, this must be noted in the statement. Any negligent violation of this section is a gross misdemeanor. Any

intentional violation of this section is a class C felony.

---

PRODUCT ANNCOUNCEMENT:

NEW HAMPSHIRE MVR RELEASE

January 24, 2007

Dear Customer,

The state of New Hampshire now requires a state specific Release form to be filled out by you and

signed by your applicant prior to obtaining any New Hampshire motor vehicle records. Please note

that this Release must be signed by your applicant before a notary public.

You may obtain a copy of the Release at http://www.nh.gov/safety/divisions/dmv/forms/dsmv505.pdf

The following instructions will assist you in completing this form.

I.

Requested Information: Select box “B”, “Another person’s Motor Vehicle Record?”

II.

Requestor Information: List your company’s information

III.

Requested Records: Select the second box, “Driver Record (Non-Certified copy)”

IV.

Intended Use of Information: Leave this section blank

V.

Search For: Complete this section using your applicant’s information

VI.

Signed Authorization: Applicant must sign in the first box before a notary public.

You, the customer, must sign in the “Certification” box.

Please note that you are prohibited under New Hampshire law from requesting any motor vehicle

records from the state without first filling out this Release. You are responsible for the retention of this

Release for no less than five (5) years. Please refer to Title XXI, Chapter 260, Administration of

Motor Vehicle Laws: Powers and Duties, Section 260:14 for specific information regarding the

retention of records. Retention of this Release and other covered records is very important. The state

of New Hampshire may request these Releases in a random audit. If an audit does occur, either Trak-1

or the New Hampshire Department of Motor Vehicles will contact you requesting copies of the

Release(s).

If you have any questions, please contact your Account Representative.

Thank you for your cooperation,

Your Product Delivery Team.

---

RELEASE OF

MOTOR VEHICLE

RECORDS

(Pursuant to RSA 260:14)

NH DEPARTMENT OF SAFETY

Division of Motor Vehicles

23 Hazen Drive, Concord, NH 03305

Tele:

Driver Records

(603) 271-2322

Registration

(603) 271-2251

Repro/Accidents

(603) 271-2128

Title

(603) 271-3111

Fax

(603) 271-1061 (all areas)

Form DSMV 505

(Rev. 03/05)

I. Requested Information: Are you requesting:

A.

Your Motor Vehicle Record?

B.

Another person’s Motor Vehicle

Record?

The back of this form must be completed and notarized.

C.

Another person’s Motor Vehicle

Record as an authorized agent of

A

your

Certificat

employer

e of Authority must

or a

accompany

company?

this request, or one

must be on file with the Division of Motor Vehicles.

II. Requestor Information:

Name of Requestor

: ____________________________________________________

Employer/Company

(If applicable): _______________________________________________

Address: ________________________________________Tele.#: ___________________

City: ___________________________________ State: __________ Zip: ______________

III. Requested Records:

Driver Record (Certified copy):

$ 10.00

Driver Record (Non-Certified copy):

$ 8.00

Driver Record (Insurance copy):

$ 8.00

Registration Listing (Current Information Only): $ 5.00

Registration (Certified copy):

$ 10.00

Title Search:

$ 20.00

License Applications and Letters of Verification: $ 10.00

Insurance Card (Accident use only):

$ 1.00

Accident Report

(Requestor will be notified of cost):

$ 1.00 per page ($5.00 minimum)

Other: _______________________________: $______

Make checks payable to “State of NH – DMV”

IV. Intended Use of Information:

IMPORTANT: To be completed only if you checked Box C above

For use in connection with any civil, criminal, administrative or arbitral proceeding.

Docket # _____________________ Court: ____________________[RSA 260:14 V (a)(2)].

By a bank or similar institution to verify the accuracy of personal information submitted by

the individual to the bank [RSA 260:14 V (a)(3)].

For providing notice to the owner(s) of a towed or impounded vehicle [RSA 260:14 V (a)(5)].

For use by any private investigative agency or security service licensed by this state for any

purpose permitted pursuant to RSA 260:14, V (a), other than for bulk distribution for

surveys, marketing or solicitations pursuant to RSA 260:14, V (a)(8)

__________________________

[RSA

260:14

V

(a)(6)].

Indicate specific reason here

By an employer or its agent or insurer to obtain or verify information relating to a holder of a

commercial driver’s license [RSA 260:14 V (a)(7)].

By a public utility to perform its public service obligation provided the individual has given

their express consent [RSA 260:14, V (a)(9)].

For an insurance company or by its authorized agent [RSA 260:14 IV (a)(2)].

Vehicle or boat information only.

For use by a life insurance company authorized to write life insurance policies in New

Hampshire, or its authorized agent.

In checking off this box, I represent that the

named person’s written consent to the release of the record has been obtained

and that the record will be used solely in connection with claims investigation,

rating, and underwriting. ________________

[(RSA 260:14, V(a)(10)]

(Initial here)

V. Search For (provide all applicable information):

Name:____________________________________________

Date of Birth: ______________________________________

Registration/Plate #: _________________________________

Driver License/I.D. #: ________________________________

Vehicle Identification #: ________________________________

Last Known Address: ________________________________

__________________________________________________

Date of Accident: ____________________________________

Location of Accident: _________________________________

Route/Street

City/Town

Other Identification Information:

____________________________________

***Reverse Side Must Be Completed Before Processing***

---

VI. Signed Authorization:

If you are requesting your record be released to another person, the authorization of the person listed in

Section V “Search For”

must be acknowledged by a Notary Public or a Justice of the Peace on the back of

this form.

Notary Public / Justice of the Peace Acknowledgement:

I authorize my record to be released to a third person:

____________________________________________________ Date:_____________

(Signature)

State of _______________, County of: ___________________ss Date: _____________

The above named ______________________________ personally appeared and made oath

that the above declaration by him is true.

In witness whereof I hereunto set my hand and official seal:

_____________________________________

_______________________

Notary Public/Justice of the Peace

Commission Expiration

Certification:

I have read RSA 260:14 and I understand the

limitations placed on the use of information

received by the Department of Safety. This form

is signed under penalty of unsworn falsification

pursuant to RSA 641:3 and subject to the

penalties specified in RSA 260:14, IX.

____________________________________

Signature of Requestor

Date: _____________

VIII. PENALTY CLAUSE:

RSA 260:14, IX states as follows:

(a) A person is guilty of a class B misdemeanor if such person knowingly discloses information from a department record

to a person known by such person to be an unauthorized person; knowingly makes a false representation to obtain

information from a department record; or knowingly uses such information for any use other than the use authorized by the

department. In addition, any professional or business license issued by this state and held by such person may, upon

conviction and at the discretion of the court, be revoked permanently or suspended. Each such unauthorized disclosure,

unauthorized use or false representation shall be considered a separate offense.

(b) A person is guilty of a class B felony if, in the course of business, such person knowingly sells, rents, offers, or exposes

for sale motor vehicle records to another person in violation of this section.

OFFICIAL USE ONLY

Date Received:_______________________

Date Sent:___________________________

Type of Identification:

Valid Photo Driver License

State-issued Photo ID

Valid Military Identification

Valid Passport

Birth Certificate

Other (specify) __________

ID Number _____________________________________

_______________________________________________

______________________________________

Employee Verifying Applicant Identification (Print Name)

Signature

-----------------------------------------------

DO NOT WRITE BELOW THIS LINE

----------------------------------------------

---

MVR Turnaround & Fee Schedule

Last Updated 1.1.2008

*All times shown are Pacific Standard Time.

**Report turnaround is based on experience. Report turnaround times and State Fees are subject to change without notice.

STATE

TURNAROUND

CUT-OFF

(Non-Instant)

TURNAROUND

(Non-Instant)

REPORTS RETURNED

(Non-Instant)

STATE FEE

EFFECTIVE

DATE

Alabama

INSTANT

N/A

N/A

N/A

$7.00

1/1/08

Alaska

NON-INSTANT

3:45p

ONE DAY

7:10a

$5.00

1/1/08

Arizona

INSTANT

N/A

N/A

N/A

$6.25

1/1/08

Arkansas

INSTANT

N/A

N/A

N/A

$11.50

1/1/08

California

NON-INSTANT

2:30p

ONE DAY

7:00a

$2.00

1/1/08

Colorado

INSTANT

N/A

N/A

N/A

$2.20

1/1/08

Connecticut

INSTANT

N/A

N/A

N/A

$16.00

1/1/08

Delaware

INSTANT

N/A

N/A

N/A

$15.00

1/1/08

Dist. Of Columbia

INSTANT

N/A

N/A

N/A

$7.00

1/1/08

Florida

INSTANT

N/A

N/A

N/A

$3.15

1/1/08

Georgia

INSTANT

N/A

N/A

N/A

$7.00

1/1/08

Hawaii

NON-INSTANT

3:30p

2 DAYS

5:00p

$9.00

1/1/08

Idaho

INSTANT

N/A

N/A

N/A

$5.50

1/1/08

Illinois

INSTANT

N/A

N/A

N/A

$12.00

1/1/08

Indiana

INSTANT

N/A

N/A

N/A

$7.50

1/1/08

Iowa

INSTANT

N/A

N/A

N/A

$8.50

1/1/08

Kansas

INSTANT

N/A

N/A

N/A

$6.50

1/1/08

Kentucky

INSTANT

N/A

N/A

N/A

$5.00

1/1/08

Louisiana

INSTANT

N/A

N/A

N/A

$6.00

1/1/08

Maine

INSTANT

N/A

N/A

N/A

$7.00

1/1/08

Maryland

INSTANT

N/A

N/A

N/A

$9.00

1/1/08

Massachusetts

INSTANT

N/A

N/A

N/A

$7.00

1/1/08

Michigan

INSTANT

N/A

N/A

N/A

$7.00

1/1/08

Minnesota

INSTANT

N/A

N/A

N/A

$5.00

1/1/08

Mississippi

INSTANT

N/A

N/A

N/A

$11.00

1/1/08

Missouri

INSTANT

N/A

N/A

N/A

$1.25

1/1/08

Montana

INSTANT

N/A

N/A

N/A

$7.25

1/14/08

Nebraska

INSTANT

N/A

N/A

N/A

$3.00

1/1/08

Nevada

INSTANT

N/A

N/A

N/A

$7.00

1/1/08

New Hampshire

INSTANT

N/A

N/A

N/A

$9.00

1/1/08

New Jersey

INSTANT

N/A

N/A

N/A

$10.00

1/1/08

New Mexico

INSTANT

N/A

N/A

N/A

$2.50

1/1/08

New York

INSTANT

N/A

N/A

N/A

$7.00

1/1/08

North Carolina

INSTANT

N/A

N/A

N/A

$8.00

1/1/08

North Dakota

INSTANT

N/A

N/A

N/A

$3.00

1/1/08

Ohio

INSTANT

N/A

N/A

N/A

$2.00

1/1/08

Oklahoma

NON-INSTANT

2:30p

ONE DAY

5:15a

$11.00

1/1/08

Oregon

NON-INSTANT

N/A

Up to 1 week

N/A

$4.00

1/1/08

Pennsylvania

NON-INSTANT

Special Notarized

Auth Form Required

N/A

1-2 weeks

N/A

$10.25

1/1/08

Rhode Island

INSTANT

N/A

N/A

N/A

$19.50

1/1/08

South Carolina

INSTANT

N/A

N/A

N/A

$7.25

1/1/08

South Dakota

INSTANT

N/A

N/A

N/A

$4.00

1/1/08

Tennessee

INSTANT

N/A

N/A

N/A

$7.00

1/1/08

Texas

INSTANT

N/A

N/A

N/A

$6.50

1/1/08

Utah

INSTANT

N/A

N/A

N/A

$9.00

1/1/08

Vermont

INSTANT

N/A

N/A

N/A

$13.00

1/1/08

Virginia

INSTANT

N/A

N/A

N/A

$7.00

1/1/08

Washington

NON-INSTANT

Special Auth Form

Required

1:00p

ONE DAY

7:00a

$10.00

1/1/08

West Virginia

INSTANT

N/A

N/A

N/A

$8.00

2/1/08

Wisconsin

INSTANT

N/A

N/A

N/A

$5.00

1/1/08

Wyoming

NON-INSTANT

4:00p

ONE DAY

5:30p

$3.00

1/1/08