AGENT/ CUSTOMER PASSWORD REQUEST FORM (Rev
AGENT/ CUSTOMER PASSWORD REQUEST FORM (Rev. 10/01)
CTT STARTER FILE IMAGING SYSTEM
Web Site Administrator · 203/324-5767 · 203/358-8974 (fax) ·
Fill out this section and forward the form to your CTIC/Ticor Agency or Sales Representative.
USER INFORMATION (PLEASE TYPE OR PRINT):
Agency ID______
LAST NAME: ______
FIRST NAME: ______
COMPANY/FIRM (IF CUSTOMER): ______
Or
AGENCY NAME (IF AGENT): ______
ADDRESS: ______
CITY/STATE/ZIP: ______
PHONE: ______FAX: ______
E-MAIL ADDRESS: ______
USER ACKNOWLEDGMENT:
I recognize that in applying for access to Chicago Title Insurance Company’s starter file Web site, the Company hereby grants to me a non-exclusive, revocable right to access Chicago Title Insurance Company’s starter file Web site in accordance with policies and procedures applicable to the operation of the site. The Company may withdraw my right of access to Chicago Title Insurance Company's starter file Web site at any time in its sole discretion.
My use of Chicago Title Insurance Company’s starter file Web site shall be governed by any manuals, guidelines, rules or procedures applicable to its use, as such manuals, etc. may be amended, distributed or electronically posted from time to time. Chicago Title has the right to assess a fee for the use of this site, upon notification to the customer.
I recognize that I am expected to comport with standards of decency and fairness, which is the norm in other forms of business communication. Specifically prohibited, without limitation, is any use of the system that can be construed as libel, slander, defamation, harassment or illegal activity.
I acknowledge that the Company reserves the right to withdraw privileges for any user at any time for any reason including, but not limited to, not comporting to such standards in his/her participation or otherwise abusing the intended and expected use of the starter file Web site.
The Company assumes no liability or responsibility for the accuracy of, or any errors or omissions in, the information contained on the starter file Web site. Such information is being provided on an "as is" basis, to provide starter information for the issuance of new CTI title insurance policies.
UNAUTHORIZED OR FRAUDULENT ACCESS TO THIS SYSTEM OR TAMPERING WITH ITS CONTENTS IS A FEDERAL CRIME (U.S.C. §2510) AND MAY BE PUNISHABLE BY A $250,000 FINE AND IMPRISONMENT FOR UP TO TWO YEARS.
THIS AGREEMENT IS MADE AND ENTERED INTO THIS ______DAY OF ______, 20___ BY AND BETWEEN CHICAGO TITLE INSURANCE COMPANY (THE COMPANY) ON BEHALF OF THE MEMBERS OF THE CHICAGO TITLE AND TRUST FAMILY OF COMPANIES AND
______.
(USER SIGNATURE REQUIRED)
DO NOT WRITE BELOW LINE – FOR CTIC/TICOR USE ONLY
CTIC CONTACT: Fill out this section and fax completed form to the Web Site Administrator at 203/358-8974. The Web Site Administrator will process form and contact the customer/agent with a user name and password.
CTIC CONTACT SIGNATURE (REQUIRED): ______
PRINT NAME: ______DATE: ______
TITLE: ______COMPANY: ______
OFFICE LOCATION: ______PHONE: ______