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Date:
Individual's AuctionACCESS ID:
To Whom It May Concern:
The individual referenced below (“Individual” or "you") wishes to register, as of the date listed above, with AutoTec,
LLC’s AuctionACCESS System. You hereby authorize AutoTec, LLC, its affiliate Auction Insurance Agency, and those of
its customers that subscribe to AutoTec’s AuctionACCESS System (including Manheim, Inc. and its affiliates, ADESA,
Inc. and its affiliates, and all other subscribing auctions) and at which you deal (or otherwise provide any
AuctionACCESS number) at any time (“Customers”) to provide, obtain, store, use and share amongst themselves, and
externally, as each sees fit, the information contained on this application, on any other forms provided to AutoTec, and
other information regarding you and/or your dealings with each, including transaction, bank, and credit information
and consumer reports. You understand that AutoTec provides this information to said Customers without verifying the
same, on an “as is” basis, expressly disclaiming any express or implied warranties regarding such information.
Customers are not limited to businesses engaged in the automobile dealer or auction industries, but may also include
other businesses providing goods or services to such industries. By signing below, the you (1) agree to the terms of
this registration and AutoTec's Terms and Conditions (as they may be amended from time to time) posted on
www.AuctionACCESS.com, (2) warrants that you are solvent and the information provided herein is complete, accurate
and truthful, (3) acknowledges that registration in the AuctionACCESS System is no guarantee of purchasing privileges
or credit with any customer, (4) agrees to be bound by the policies and procedures of each Customer with whom you
deal or attend, (5) agrees that AutoTec, LLC, Auction Insurance Agency, and subscribing Customers may contact the
you, on their own behalf or on behalf of their respective sellers, consignors, or other customers, for any commercial or
advertising purpose, using the telephone numbers (whether business, home or mobile numbers), fax numbers, e-mail
addresses, and other contact information provided on this form, or at any other address, telephone number, fax
number or e-mail address used in connection with the Individual’s business, and (6) agrees to disclose AuctionACCESS
numbers only to subscribing Customers. You agree that these terms and any other commitments or account forms
submitted by you to AutoTec, its affiliates, and any Customers shall have the same force and effect as though
personally signed by you and may be enforced as originals, even if they were accepted online, by email, via "click-
through" agreement, or in other digital, pdf, or facsimile format.
Date of Birth:
Taxpayer ID Number:
(US:SSN; MX: CURP; Other:N/A)
Photo ID Number:
Home Address:
City:
Country:
Postal Code:
Home Telephone:
Mobile Telephone:
Colony (if applicable):
Voter Registration Card (Mexico Only)
Passport
State/Province Issued ID
Driver's License
Individual Authorization Letter
Individual Signature
Printed Legal Name of Individual
State/Province or Country:
Agreement
Contact Information
Issue Date:
Expiration Date:
Email:
IAL Form (Rev. 08/01/2013)
© Copyright 1998-2013 AutoTec, LLC. All rights reserved.
Individual Authorization Letter
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