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LAW ENFORCEMENT AGENCY REQUEST FORM TO ACCESS TLO SYSTEMS
(***LAW ENFORCEMENT ONLY****)
TLO Is dedicated to creating technologies, systems, and tools that protect children, people, companies, and
countries from risk, fraud and theft. TLO applauds the efforts of our law enforcement officers across the country
in the fight against crime, and is proud to provide our tools free of charge to Law Enforcement Agencies to aid
the fight against crime.
TLO requires the Agency's legal designee to make application as follows:
“Law Enforcement Agency
Agency Name: [EI Mirage Police Department |
Agency Address: {12145 NW Grand Ave, EI Mirage, AZ, 85335-2984 |
Agency Phone #: Agency Web Site: [www.cityofelmirage.org/police _|
Agency ORI: [AZ0070700 | | Number of Sworn Positions inthe Agency: [50-99 _—‘|
Name: [Steven W. Campbell |
Direct Phone #: {623-433-9510 | | E-mail Address: [scampbell@cityofelmirage.org |
Officer or Command Staff Rank With Authority to Bind the Agency
“Authorized Agency Designee
Name: [Aimee Currey (Sgt Craig Cormier) |
Division: [
Rank: [Crime Analyst (Admin Sgt) | | \D/Badge Number: [9863 (3231) |
Direct Phone #: [6234339519 | | E-mail Address: [acurrey@cityofelmirage.org _ |
Cell Phone #: [602-434-6462 |
Revised 1/14/11 Subscriber fnitiats
Account # 233026 Page 1 of 5
: ‘Account Administrator (The person responsible for managing your account on behalf of the Agency.)
Name: | Aimee Currey |
Division: — [Administration |
Rank: {Crime Analyst | | ID/Badge Number: [9863
Address (if not Headquarters): [ |
Direct Phone #: [623-433-9519 _] | Cell Phone #: [602-434-6462 ]
E-mail Address: [acurrey@cityofelmirage.org J
The responsibilities of the Administrator are:
1,To coordinate the appropriate use of TLO Systems according to the agreed Acceptable Use
Requirements.
2.To keep current a complete roster of all Officers who have been granted rights to access and use TLO
Systems, and to monitor appropriate use.
3.To we, jafoymation to TLO to ensure the appropriate use and control of TLO Systems.
4 - :
Signed By: Lolo 393) LIMA 3, —
tized Agency Designee : Administrator ©
3 hs ly BAT. 1]
Hate Date
Subscriber Initials
Revised 4/14/11
Page 2 of §
Account # 233026
GIL
TLO Acceptable Use Requirements for Law Enforcement:
TLO is dedicated to creating technologies, systems, and tools that protect children, people, companies, and
countries from risk, fraud and theft. TLO applauds the efforts of our law enforcement officers across the country
in the fight against crime, and is proud to provide our tools free of charge to Law Enforcement Agencies to aid
the fight against crime.
1, The Authorized Agency Designee of the Agency must make application for the Agency overall. Once
approved, an administrator will be appointed by the Agency to oversee the use of TLO Systems by the Agency,
including authorizing access, ensuring appropriate use, and removing access for any Officer who is
reassigned.
2, Subject to these Acceptable Use Requirements, TLO grants a license to the Agency to permit online access
to TLO Systems at no charge solely for law enforcement purposes. You must acknowledge and agree to these
Acceptable Use Requirements by signing this Acceptable Use Requirements form, and strictly abiding by the
requirements included here.
3. The Agency understands and acknowledges that data is sometimes entered poorly, processed incorrectly,
and generally not free from defect. The results found from TLO Systems should not be relied upon as accurate.
Before relying on any information provided by TLO Systems, you must verify it independently through other
investigative means in accordance with your Agency's guidelines and protocols. The Agency agrees to hold
TLO harmless for any of the Agency's use of the TLO Systems and the information provided by TLO Systems.
4. Members of the Agency must not share access to TLO Systems with anyone who is not in the Agency.
5. You will not use or allow use of TLO Systems for any commercial purposes,
6. Use of TLO Systems, and access to any information provided by TLO Systems, may be suspended or
revoked at any time by TLO.
7. The Agency agrees it is familiar with laws governing the use of data. The TLO Systems contain data
regulated by the Gramm-Leach-Bliley Act, 15 U.S.C. Section 6801 et seq. ("GLB"), and the Driver's Privacy
Protection Act, 18 U.S.C. Section 2721 et seq. ("DPPA"). The screens that display information from the TLO
Systems clearly indicate that the results are to be used for Law Enforcement Purposes only; GLB and DPPA
permit data to be used for Law Enforcement Purposes. You will also have an option to suppress any GLB and
DPPA data, if you are ever in doubt, since for each use, you must comply with the GLB and DPPA permissible
uses.
(A) Applicable GLB uses for law enforcement:
¢ To the extent specifically permitted or required under laws other than GLB, and in accordance
with the Right to Financial Privacy Act of 1978, to law enforcement agencies, to self-regulatory
organizations, or for an investigation on a matter related to public safety.
* To protect against or prevent actual or potential fraud, unauthorized transactions, claims, or
other liability.
Revised 1/14/14 Subscriber Initia!s
Account # 233026 Page 3 of 5
® To comply with Federal, State, or local laws, rules and other applicable legal requirements.
(B) Applicable OPPA uses for law enforcement:
e Use by any government agency, including any court or law enforcement agency, in carrying
out its functions, or any private person or entity acting on behalf of a Federal, State, or local
agency in carrying out that agency's functions.
* Use in connection with any civil, criminal, administrative, or arbitral proceeding, in any Federal,
State, or local court or agency, or before any self-regulatory body, Including the service of
process, investigation in anticipation of litigation, and the execution or enforcement of
Judgments and orders, or pursuant to an order of a Federal, State, or local court.
8. TLO is not a consumer reporting agency. The Agency shall not use TLO Systems for any purpose governed
by the federal Fair Credit Reporting Act, 15 U.S.C. Section 1681 et seq. ("FCRA"), including to determine
eligibility for credit, insurance, employment, or other purpose governed by the FCRA.
9. The Agency will manage its account in compliance with Agency guidelines and these Acceptable Use
Requirements, including, without limitation: (i) designating an appropriate Administrator: {ii) adding appropriate
Agency employees as users; (iii) maintaining accurate records of all current employees with access to, and
former employees who have ever accessed, TLO Systems; (iv) issuing guidelines for the appropriate use of
TLO Systems by its users; and (v) terminating access when a user departs from the Agency, transfers to new
duties not requiring access, or is suspected of improper access or use of TLO Systems.
10. The Agency may not assign the license to’access TLO Systems, in whole or in part.
All of the foregoing is accepted and agreed to by:
4
Signed By: LE fo B02) shes lL)
AuthOhized Agency Designee Date
Please complete and attach the following documentation. For legal questions, please contact Derek Dubner,
Esq. at (561) 988-4205.
* Law Enforcement Identification Cards for the Authorized Agency Administrator.
® Law Enforcement Agency Request Form and TLO Acceptable Use Requirements - All fields must be
completed.
Fax the information to Credentialing at (561) 226-9717 on Department/Agency letterhead.
Revised 1/14/14 Subscriber Initials
Account # 233026 Page 4 of 5
REQUIRED DOCUMENTS
* Completed Subscriber Agreement & Application
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