KeyCodes Access

Application

Brooklyn,NY11230 (718)404-9691

Pleasesubmitalloftheitemsbelowtousviafax:(718)404-9691 or Email:. Alltheinformationprovidedonyourapplicationwillbeverified.

Wewillsendyouanemailconfirmationafteryourbackgroundcheckhasbeencompletedandallitemshavedocumentsprocessed. Pleaseallowupto6businessdaysforapproval.

AUTOCODEReservestherighttocancel\declineserviceatanytimeandforanyreasonwithout notice.

CompanyApplicationGovernmentIssuedPhotoID(foreachuser) BusinessLicense AdditionalAuthorizedUserApplication(s)

CreditCardAuthorizationLocksmithLicense(orYellowPagesadwhere licensingis notapplicable)

HOWTO ACCESSCODES:

THE SYSTEM IS AVIABLE24/7(EXCLUDING SYSTEM MAINTENANCE)

ONLINEWEBSITE:

SMARTPHONEAPP: Android2.1ornewer\AppleiPhoneOs5.2ornewer

PCSOFTWARE:ACTool

■TheVIN(VehicleIdentificationNumber)shouldbetaken fromthevehicleitselfandnot frompaperwork

■ AUTOCODE WillverifytheVIN,insomecasesAUTOCODE willnotbeabletoverify theVINsoyouwill

havetomanuallyselecttheMake,YearandModel

■ Alwaysmakesurethat Locks, ECU's,Immobilizerunitsarefactory original.

■CODESARENOTREFUNDABLE

KeyCodesAccess

CompanyApplication

AUTOCODE

Brooklyn,NY11230

(718)404-9691

COMPANYNAME

ADDRESSCITYSTATEZIP

OFFICEPHONECELLPHONEFAX

EMAILADDRESSTAXID#LOCKSMITHLICENSE

OWNERNAMEDRIVER’SLICENSESTATE

CorporationLLCPartnershipSoleProprietor

TRADEREFERENCES / COMPANYNAME / CONTACTNAME / PHONE / ACCOUNT#
ADDRESS / CITY / STATE / ZIP / DATEACCTESTABLISHED
COMPANYNAME / CONTACTNAME / PHONE / ACCOUNT#
ADDRESS / CITY / STATE / ZIP / DATEACCTSTABLISHED
COMPANYNAME / CONTACTNAME / PHONE / ACCOUNT#
ADDRESS / CITY / STATE / ZIP / DATEACCTESTABLISHED

Wecannot provideanycodesuntilwereceiveacopyofthefollowing: BusinessLicense,LocksmithLicense(whereapplicable)orothersimilardocumentation, andaDriver’sLicenseforeachemployeethat willbesubmittingrequests.Thenormaltimeneededtoprocess acoderequestis5to30minutes.Exceptionsand longertimesmayoccur. Notallcodesareavailableafter5:30pmCST.Youwill becontactedbyphone, emailorfaxwhentherequestedcodeisavailable.Neither AutocodenorJNZTWebServicesareresponsibleifthecodesarenolongercompatiblewithanylocks orenginecontrol computers thathavebeeninstalledafter theinitialproductiondate.Pleaseallowupto3businessdaysforapprovalofyourapplication.

TERMSCONDITIONS / INITIALS / DATE / ThekeycodesandinformationIreceiveareforusewithinthestatedcompanyandwillnotbesoldorgiventoanyone outsideofmycompany.
INITIALS / DATE / IwillusetheinformationIreceivefromAutocodeandJNZTWeb Servicesinalawfulmanner.
INITIALS / DATE / Iherebyagree toabsolve,defend,indemnifyandholdharmless:theowners,management,employees, subcontractors,andaffiliatesofAutocode fromany andall claimsarisingfromtheauthorizedorunauthorizeduse oftherequested,specifiedandacknowledgedservicesdescribedherein.
INITIALS / DATE / IdeclarethatIamrequesting vehicleinformationonbehalfofmycustomerandIwill examinetheirdriver’slicense andeithertitleorregistrationtoprovetheyarethevehicleowner.
INITIALS / DATE / IwillnotretainanycodesobtainedfromAutocodeorJNZTWebServicesafterservicesarecompleted.
INITIALS / DATE / IunderstandthataviolationofthisagreementwillterminatemybusinessrelationshipwithAutocode.
IamacknowledgingandgivingpermissiontoAutocodeandJNZTWebServicestorunabackgroundcheckonmyself,mycompanyandany individualsassociatedwiththeaccessingofkeycodeinformation.Idosolemnlyswear,affirm,andpromiseundercriminalpenaltyofa felonyfor fraudulentuseofafalseorfictitiousnameoraddressorformakingafalsematerialstatementpunishablebyfinesofupto$10,000orbyimprisonment ofuptofiveyears,orboth,thatthestatementscontainedhereinaretrueandaccurate.Aviolationofanypartofthisagreementwillcausethe terminationofbusinessrelationswithAutocodeand/orJNZT WebServices.IunderstandthatphoneconversationswithAutocodeandJNZTWeb Servicesmayberecordedforsecuritypurposes.
PRINTNAME / TITLE
SIGNATURE / DATE
FORAUTOCODEUSEONLY / REVIEWEDBY / DATE / NOTES

AdditionalAuthorizedUser

COMPANYINFORMATION / COMPANYNAME
ADDRESS / CITY / STATE / ZIP
Astheemployer,Ihereby agreetooverseeandtakeresponsibilityfortheproperuseofanykeycodesgiventomycompany.
PRINTNAME / TITLE
SIGNATURE / DATE
EMPLOYEE INFO / EMPLOYEENAME
PHONE / DRIVER’SLICENSESTATE / LOCKSMITHLICENSE

Wecannotprovideanycodesuntil wereceiveacopyof thefollowing:CompanyApplicationwithsupportingdocumentation,EmployeeLocksmith License

(whereapplicable)orothersimilardocumentation,andaDriver’sLicenseforeachemployeethatwillbesubmittingrequests.

TERMSCONDITIONS / INITIALS / DATE / ThekeycodesandinformationIreceiveareforusewithinthestatedcompanyandwillnotbesoldorgiventoanyone outsideofmycompany.
INITIALS / DATE / IwillusetheinformationIreceivefromAutocodeandJNZTWebServicesinalawfulmanner.
INITIALS / DATE / Iherebyagree toabsolve,defend,indemnifyandholdharmless:theowners,management,employees, subcontractors,andaffiliatesofAutocode fromany andall claimsarisingfromtheauthorizedorunauthorizeduse oftherequested,specifiedandacknowledgedservicesdescribedherein.
INITIALS / DATE / IdeclarethatIamrequesting vehicleinformationonbehalfofmycustomerandIwill examinetheirdriver’slicense andeithertitleorregistrationtoprovetheyarethevehicleowner.
INITIALS / DATE / IwillnotretainanycodesobtainedfromAutocodeorJNZTWebServicesafterservicesarecompleted.
INITIALS / DATE / IunderstandthataviolationofthisagreementwillterminatemybusinessrelationshipwithAutocode.
IamacknowledgingandgivingpermissiontoAutocodeandJNZTWebServicestorunabackgroundcheckonmyself.Idosolemnlyswear, affirm,andpromiseundercriminalpenaltyofafelonyforfraudulentuseofafalseorfictitiousnameoraddressorformakingafalsematerialstatement punishablebyfinesofupto$10,000orbyimprisonmentofuptofiveyears, orboth,thatthestatementscontainedhereinaretrueand accurate.A violationofanypartofthisagreementwillcausethe terminationofbusinessrelationswithAutocodeand/orJNZTWebServices.I understandthat phoneconversationswithAutocodeand JNZTWebServicesmayberecordedforsecuritypurposes.
PRINTNAME / TITLE
SIGNATURE / DATE

COPYOFEMPLOYEE’S GOV’TISSUED PHOTOID MUSTACCOMPANY

THISAUTHORIZATION

FORAUTOCODEUSEONLY / REVIEWEDBY / DATE / NOTES

CreditCardAuthorization

CARDINFONRMATION / COMPANYNAME / NAMEONCARD
BILLINGADDRESS / CITY / STATE / ZIP
PHONEFORCREDITCARD / FAX / EMAILADDRESS
CARDNUMBER / EXPIRATIONDATE / CVV / TYPE
VISA MC AMEX \ DISC
AUTHORIZATION / I hereby authorize AutocodeIncand JNZTWeb Services to automatically charge the credit card listed above on the 1st and 15th day of each month for invoiced charges. A detailed statement will follow via email or fax number provided. I also agree to abide by the conditions set forth in the card issuer’s agreement.
In the event of litigation relating to the subject matter of this Agreement, the non-prevailing party shall reimburse the prevailing party for all reasonable attorney, merchant and credit card processor fees and costs.
SIGNATURE / PRINTNAME / DATE

COPYOFCARDHOLDER’SGOV’TISSUED PHOTO ID MUSTACCOMPANYTHISAUTHORIZATION