United Software Developers Inc.

MVR NEW ACCOUNT SET UP FOR INSURANCE AGENTS ONLY
(If you are other than an Insurance agent, click here to be directed to the correct page)

Step 1:

Complete the [ MVR CORPORATE ACCOUNT REQUEST FORM ]

Step 2:

E-mail, Fax or Mail the following documents to open a MVR account:

Completed Insurance Agent Agreement (All pages must be initialed)
Completed MVR Corporate Account Request Form (All pages must be initialed)
Copy of Business License (Account Administrator)
Copy of Driver’s License (Account Administrator)
Check payable to: United Software Developers, Inc.

NOTE: A minimum deposit of $200 is required to open a MVR account. This amount will be applied to your account.

E-MAIL:       USDMVR@AOL.COM
FAX:             ATTN: Helen Gelb (718) 407-1425
MAIL:           United Software Developers, Inc.
                      2913 Avenue V
                      Brooklyn, NY 11229
                      ATTN: Helen Gelb

Once your agreement is approved you will receive an email confirmation with your account number and detailed instructions.

Approval can take up to 48 hours but is usually sooner.

Should you have any questions, please contact: Helen Gelb at (718) 648-5300 ext. 204

MVR CORPORATE ACCOUNT REQUEST FORM

GENERAL INFORMATION

Please complete all

Company Name

DBA Name

Physical Address

Please complete all

Address

City

State

Zip

* Wrong Zip code format

Mailing Address

Same as physical

Contact Info

Contact Person

Title

Phone

Wrong phone number format

Fax

E-Mail Address

* Wrong format of e-mail address

What USER NAME would you like to use?
(4 - 10 characters please)

* User name must be 4-10 alpha numeric characters long

What PASSWORD would you like to use?
(4 - 10 characters please)

* Password must be 4-10 alphanumeric characters long

Other Info

FEIN

Ownership Type

State of Incorporation

Date of Incorporation

Website

Insurance License #

Insurance License State

Insurance License Expires

California Agreement Number

California Requester Code

How did you hear about us?

OWNERSHIP

Individual or each corporate officer of the business

First officer

Firstname

Middlename

Lastname

Title

SSN

Second officer

Firstname

Middlename

Lastname

Title

SSN

BUSINESS TYPE

Please select one

Insurance Agency (MGA, Broker)

Insurance Company

Other (please describe)

PAYMENT INFORMATION

Please complete all

Full Bank Name

Bank Address

Bank Routing Number

* Only digits allowed in Bank Routing Number

Account Number

* Only digits allowed in Account number

Check Number

* Only digits allowed in check number

Amount for Account Deposit

$ minimum $200 required* Amount cant be less than $200 and more than $10 000 000

Please Choose Your Payment Option

AUTOMATED ACCOUNT (Preferred Option)

A minimum deposit of $200 (optional $500 or $1,000) is required for your escrow account. When your account balance is $50 or less, the system will automatically generate a draft from your account in the amount of $200 (optional $500 or $1,000), update your escrow account and send you an e-mail confirmation along with a copy of the draft for your records. It will take 2 - 3 days before the deposit shows on your account, but the money will be available immediately in your escrow account to run MVRs.

Please select your escrow account minimum:

200 500 1000

WATCH YOUR OWN ACCOUNT

If you choose to watch your own account, you have the following payment options:

1) Online Payment. Link: http://www.usdsoftware.com/pay_usd (Payment is credited instantly)

2) Check by Phone Payment. Call (718) 648-5300 ext. 204 (Payment is credited instantly)

3) Check by Fax Payment (Payment is credited instantly during business hours 9 AM - 5 PM, Monday-Friday)

Please note that watching your own account means that if you run out of money in your escrow account and don't submit a payment, you wont be able to run MVRs until you make a payment