Cityfax Order Form

*Attention*

Complete the General Order/Pricing Form (below) and someone from our staff will contact you with exact pricing and time Service information and answer any questions you may have.

General Order/Pricing Inquiry Form

Fill in Your Account Information:
Fields marked with an * are required

Company Name *
Requestor Name *
Fax Number *
Phone Number *
Email Address *
Choose What Service You Want:
Risk Assessment Aids
Loan Administration Aids
Collection Reporting Aids
Litigation Aids

Fill in the Property Information/Search Criteria:
Your Quoteback/FileNo
Corporate Name
or
Guarantor Name
Property Address
City
Province
Estimated Value
Legal Description (if available)
Special Instructions

Payment Information: We're ready to perform the Special Reporting Service(s) you have requested, we just need your credit card information. This is a secure transaction. Once approved, we will process your request.
If you're ready with your credit card information, we're ready to proceed. Credit Card: Please check off which card you're using. : Name as it appears on Card : * Credit Card Number : * Expiry Date on Card :* Month Year
Client Consent I First Middle Last Name Initial Name hereby confirm that the information as provided is complete, accurate and correctly reflects "Services" required. I have read, understand and/or agree with the Terms of Service Agreement and Cityfax Privacy Policy. I do authorize the above order and the Cityfax charges to be processed on the credit card, as provided. Further, by pressing "Submit" button I/we consent to the collection, use and disclosure of information; provided to Cityfax, for the sole purposes of completing "Services Requested". This could involve disclosure to various Federal/Provincial authorities, responsible for administering programs and/or data files.

You can now download our order form in format. Order Form

Which can be filled out and either E-mailed to us OR printed out and faxed to us.
You can get the Acrobat Reader for Free here: