5r1- POP Mail Box Release and Hold Harmless Agreement

POP MAIL BOX NAME
USE and RELEASE AGREEMENT FORM

Click here for a printer friendly version of this form.

Please fill out the form below, then sign it. After you have fully executed the form, then please fax or mail it to Interstate Background Research.

THANK YOU

___________________________________________
Company Name

___________________________________________
Company Address

___________________________________________
Company City State ZIP

____________________________________________
Company Telephone Number

____________________@_______________________
Current Complete email Address

I, am the person named above, and I request a POP mail box @ibrinc.com.

The individual that I have named above will be the only person that I will authorize to access/use this account.

The account will be used only to send business information and other business related data to, and in some to cases receive data from, Interstate Background Research. The account will be utilized for no other purpose, personal or otherwise.

I agree that I will not alter the parameters, including the password of the mail address/box.

I agree that I will not use, or allow to be used, this address/mailbox/account for any immoral or unlawful purpose whatever.

I understand that this account may be terminated/closed at any time by Interstate Background Research without cause or stated reason or notice to me whatever.

I understand that the contents of this mailbox are not private from authorized employees of IBRInc, and are subject to the all of the frailties and security risks of the internet.

I understand that if this mail box is not used for a period of 45 days, IBRInc may, without notice, close the box, and that IBRInc will not be responsible for any lost or non-forwarded mail.

Further, I agree to hold Interstate Background Research, Inc. harmless of all liability for any action caused directly or indirectly by me regarding the use of this mail address/box during the time that I have use privileges of this mail address/box.

____________________________________________
Your Signature

____________________________________________
Your Full Name Typed or Printed

________________@___________________________
Your email address

THANK YOU

form 5r1- mail_box rev 09/21/1999

Click here for a printer friendly version of this form.

Return to the IBRInc Home Page

Last Updated 09/21/1999 ibrinc.com