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SIGN UP FOR MVR SERVICE
MVR NEW ACCOUNT SET UP FOR ALL OTHER THAN AN INSURANCE AGENT (If you are 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    
   Mailing Address  
Same as physical
   Contact Info  
Contact Person  
Title
Phone  
Fax
E-Mail Address    
   Login Info  
What USER NAME would you like to use?
(4 - 10 characters please)		    
What PASSWORD would you like to use?
(4 - 10 characters please)		    
   Other Info  
FEIN
Ownership Type  
State of Incorporation
Date of Incorporation
Website
Insurance License #
Insurance License State
Insurance License Expires
How did you hear about us?
Years Business Established
Dun and Bradstreet #
Website
Compliance contact
Compliance E-Mail  
IT Contact
IT E-Mail  
   BUSINESS REFERENCES  
   First  
Name
Contact
Phone  
   Second  
Name
Contact
Phone  
   STORAGE RECORDS  
Same as physical
   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)
   INFORMATION MAY BE USED ONLY FOR THE FOLLOWING APPROVED PURPOSES:
  For use in connection with matters of motor vehicle or driver safety and theft; motor vehicle emissions; motor vehicle product alterations, recalls, or advisories; performance monitoring of motor vehicles, motor vehicle parts and dealers; motor vehicle market research activities, including survey research; and removal of non-owner records from the original owner records of motor vehicle manufacturers.
  For use in the normal course of business by a legitimate business or its agents, employees, or contractors, but only: • To verify the accuracy of personal information submitted by the individual to the business or its agents, employees, or contractors; and • If such information as so submitted is not correct or is no longer correct, to obtain the correct information, but only for the purposes of preventing fraud by, pursuing legal remedies against, or recovering on a debt or security interest against, the individual; provided, however the legitimate business may only be an insured state-chartered or federally chartered credit union, an insured state or national bank, an insured state or federal savings and loan association, or an insured saving only.
  For use by any insurer or insurance support organization, or by a self-insured entity, or its agents, employees, or contractors, in connection with claims investigation activities, antifraud activities, rating or underwriting.
  For use in providing notice to the owners of towed or impounded vehicles.
  For use by an employer or its agent or insurer to obtain or verify information relating to a party in interest who is a holder of a commercial driver's license.
  For use by any requestor, if the requestor demonstrates he or she has obtained the written consent of the party in interest.
  For any other use specifically authorized under the laws of the state that hold the Records, if such use is related to the operation of a motor vehicle or public safety.
   PAYMENT INFORMATION Please complete all
Full Bank Name     
Bank Address     
Bank Routing Number       
Account Number       
Check Number       
Amount for Account Deposit $ minimum $200 required   
Please Choose Your Payment Option
 
   


Copyright © 1995 - United Software Developers Inc.
2913 Avenue V, Brooklyn, NY 11229 Phone: 800-353-3755