Subscription Agreement

RecordEASE Web Subscriber Contact Information

For questions: call (612) 348-3062 or email: recordeasehelp@hennepin.us

RecordID

Customer name

Enter legal name of entity or individual requesting a RecordEASE Web subscription

Contact person

Phone number

Billing address

City

State

Zip Code

Please confirm your email address

Individual Users:

Information for individual users needed below: Email addresses will be used as the RecordEASE Web log-in ID unless otherwise specified.

Note: A temporary password will be issued and sent once the contract has been processed.

Customer name

Subscriber address

Signature

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Date

Verify Step

I have reviewed the subscription agreement and agree to the terms.