APPLICATION FOR ELECTRONIC ACCESS

Hamilton County Register of Deeds
Application For Electronic Access
PO Box 1639, Chattanooga, TN 37401
(423) 209-6560 Fax: (423) 209-6561


Date: _____ / _____ / _____	Requested Date for Service to Begin: _____ / _____ / _____

Individual Name:

________________________________________________________

Firm Name:

________________________________________________________

Type of Business:

________________________________________________________

Address:

________________________________________________________
Include street/city if reflecting P. O. Box

Work Number:_______________________
Fax Number:_________________________	Email Address:______________________________

Local Relative or Friend info CONTACT FOR EMERGENCY Include name, address, and phone at work, and home	______________________________________________ ______________________________________________
List names of all persons at this site who have been convicted of a felony	______________________________________________ ______________________________________________
Names, address, and phone numbers at work for all users at this site	______________________________________________ ______________________________________________ ______________________________________________

List of Electronic Access Fees: $50.00 per firm, location or individual per month, Free copies.

A 30 day notice will be given for any future fee increases

I / We agree to inform the Register promptly of any changes to the above information.

I / We agree to use the system for read only information. I / We will not attempt to alter, delete, or impair the records maintained by the Hamilton County Register of Deeds.

I / We agree to pay the stated amounts for charges to access the records. I / We agree to pay for the copies ordered and faxed to us by the system. A balance due over 30 days will result in the account being disconnected.

I / We agree to give a 30-day written notice for cancellation of the account. No proration will be given for the days continuing to the end of the month after the 30-day notice has run.

I/We agree to use the web-form provided for all searches.

I/We agree that all uses of this account and accesses to this system will be conducted from within the United States of America.

The system will be available, subject to repair or maintenance, Mon. through Sat. 7:30 a.m. until 11:00 p.m. The fee will remain the same if we are down for maintenance.

Firm will be responsible for any user i..d.’s assigned.

Any violations of these agreements may result in the cancellation of this account without notice.

Print Signature and Sign: ___________________________________________________