This section is for personal information. Remember to enter your
home address. Please
double-check to be sure that information is complete, accurate and
legible.
Last Name
First Name
Middle Initial
E-Mail Address
Street
Address of Residence
Home Number
City / Town
State
ZIP Code
Work Number
DRIVER'S LICENSE
ATTACH ENLARGED
PHOTOCOPY
OF DRIVER'S LICENSE HERE
SIGNATURES
Please return the completed
User Registration Form with attachments to the individual in your office designated to
be the REDS Account Manager. Sign and date the form in their presence.
I (WE) CERTIFY THAT ALL INFORMATION CONTAINED ON THIS
USER REGISTRATION FORM IS ACCURATE TO THE BEST OF OUR KNOWLEDGE. IN ADDITION, I (WE)
AGREE TO THE TERMS OF USE AS OUTLINED IN THE END USER LICENSE AGREEMENT
LOCATED ONLINE.
User Signature
Date
Company Name
Account Manager's Signature (Witness)
Date
Office Account Number
Real Estate Data
Services, 2235 Packard Circle, Hummelstown, PA 17036