Additional Authorized User Application

Company Name: Driver Lic.:

Company Address: LS Lic.:

Employee Name: Employee Cell Phone:

Terms and Conditions

We can’t provide any codes until we receive a copy of the following: employer application, designate employee driver license (Each user must have a clear copy), and employee locksmith license(if in possession of their own license).

Initials Date The key codes and information I receive are for use within the stated company and will not be sold or given to anyone outside my company.

Initials Date I will use the information I receive

Initials Date

I hereby agree to absolve, defend, indemnify and hold harmless: the owners, management, employees, subcontractors, and affiliates of KeyCode Profrom any and all claims arising from the authorized or unauthorized use of the requested, specified, and acknowledged services described herein.

Initials Date I declare that I am requesting vehicle information on behalf of my customer and I will examine their driver’s license and either title or registration to prove they are the vehicle owner.

Initials Date I will turn over the key code, and all other codes obtained, to the vehicle owner and will not retain the codes after services are completed.

Initials Date I understand that a violation of this agreement will terminate my business

I am acknowledging and giving permission to KeyCode Pro to run a background check. I do solemnly swear,affirm, and promise under criminal penalty of a felony for fraudulent use of a false or fictitious name or address or for making a false material statement punishable by fines of up to $10,000 or by imprisonment of up to five years, or both, that the statements contained herein are true and accurate. A violation of any part of this agreement will cause the termination of the employer’s business relationship with KeyCode Pro.I understand that phone conversations with KeyCode Pro may be recorded for security purposes. I have read and agree to this entire document:

Employee

Signature___________________________________ Date____________________________________

As the employer, I hereby agree to oversee and take responsibility for the use of key codes given to my company:

Employer

Signature___________________________________ Date______________________________________

879 Joliet St. Suite 141Dyer, IN 46311

P: 815-774-9100F: 815-774-9540

relationship with KeyCode Pro

from KeyCode Pro in a lawful manner.

Trade Reference List

Your Company Name ________________________________

Company Contact Name Address City, State, Zip Phone/Fax Date Established

Company Contact Name Address City, State, Zip Phone/Fax Date Established

Company Contact Name Address City, State, Zip Phone/Fax Date Established

879 Joliet St. Suite 141Dyer, IN 46311

P: 815-774-9100F: 815-774-9540

Company Application

Company Name: Owner Name:

Email Address: Driver Lic.:

Physical Address: Bus. Tax ID:

Phone Number: Locksmith Lic.:

Cell Number: Rec. Agency #:

Fax Number

Terms and Conditions

We can’t provide any codes until we receive a copy of the following: driver's license (each user musthave a clear copy), business license, locksmith license (or recovery license where applicable). The normal time needed to process a code request is 15 to 30 minutes. Exceptions and longer times may occur. Not all codes are available after 6PM (Central). A KeyCode Pro representative will contact you by phone, email, or fax when the requested codeis available. KeyCode Pro is not responsible if the codes are no longer compatible with any locks or engine control computers that have been installed after the initial production date. Please allow up to 3 business days for approval of your application

Initials Date The key codes and information I receive are for use within the stated company and

will not be sold or given to anyone outside my company. Initials Date

Initials Date

I hereby agree to absolve, defend, indemnify and hold harmless: the owners, management, employees, subcontractors, and affiliates of KeyCode Profrom any and all claims arising from the authorized or unauthorized use of the requested, specified, and acknowledged services described herein.

Initials Date I declare that I am requesting vehicle information on behalf of my customer and I will examine their driver’s license and either title or registration to prove they are the vehicle owner.

Initials Date I will turn over the key code, and all other codes obtained, to the vehicle owner and will not retain the codes after services are completed.

Initials Date I understand that a violation of this agreement will terminate my business relationship with KeyCode Pro

I am acknowledging and giving permission to KeyCode Pro to run a background check on myself, my company and any individuals associated with the accessing of key code information. I do solemnly swear, affirmand promise under criminal penalty of a felony for fraudulent use of a false or fictitious name or address or for making a false material statement punishable by fines of up to $10,000 or by imprisonment of up to five years, or both, that the statements contained herein are true and accurate. A violation of any part of this agreement will cause the termination of business relations with KeyCode Pro. I understand thatphone conversations with KeyCode Pro may be recorded for security purposes. I understand there is a $25.00application fee. I have read and agree to this entire document. Signature__________________________________________ Date____________________________________

879 Joliet St. Suite 141Dyer, IN 46311

P: 815-774-9100F: 815-774-9540

I will use the information I receive from KeyCode Pro in a lawful manner.

Credit Card Authorization

Company Name:

Name on Card:

Address for CC:

City, State, and Zip:

Phone # for CC:

Fax Number:

Email:

Card Number:

Credit Card Type: ❒ American Express ❒ Mastercard ❒ Visa

Expiration Date:

I hereby authorize KeyCode Pro, to automatically charge the credit card or withdraw money from the bank account 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. Cardholder agrees to abide by the conditions set forth in the card issuer’s agreement. THE CARDHOLDER’S DRIVER LICENSE MUST ACCOMPANY THIS APPLICATION.

Name on Card _________________________________

Signature______________________________________ Date_______________________________

879 Joliet St. Suite 141Dyer, IN 46311

P: 815-774-9100F: 815-774-9540

(Each user must have a clear copy)

Application Checklist

Item ü

Company Application

Additional Authorized User Application(s)

Bank or Credit Card Authorization

Trade References List

Driver License Copy (Each user must have a clear copy)

Business License Copy

Locksmith License Copy (if applicable)

Recovery License Copy (if applicable)

$25.00 Application Fee (will be charged to your credit card)

Insurance certificate (Naming KeyCode Pro as additionally insured)

Please fax all the above items to 815-774-9540.. All information provided on your application will be verified. We will send you an email with a confirmation after the background check is complete and all items have been processed. Please allow 3 business days for approval. KeyCode Pro, reserves the right to cancel service at any time without notice.

Obtaining Key Code ü Fax your request form to 815-774-9540, call us at 815-774-9100,

email us at on line at www.KeyCodePro.com

ü Our operators will process your request – usually within 15-30 minutes

ü Your request will be sent to your email address on file. ü If the code does not work: verify that locks and computers are

original, verify the VIN # on your end, and then call us to make sure it was processed correctly on our end. You must call us if the code does not work to avoid being charged!

ü NO REFUNDS ON GM.

879 Joliet St. Suite 141Dyer, IN 46311

P: 815-774-9100F: 815-774-9540

Info@KeyCodePro.com or place your request