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EFS Transportation Services, Inc.
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| FTP Authorization Form |
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This form serves as formal authorization to EFS Transportation Services (EFSTS) to transmit, on a daily basis, all transaction data processed at EFS-affiliated locations pursuant to the EFS Customer Agreement. EFS Customer, for itself and for its parent companies, subsidiaries, affiliates, successors, representatives, agents, employees, partners and assigns ("Releasors"), hereby releases and forever discharges EFSTS, it affiliates, subsidiaries, successors, representatives, agents, employees and assigns ("Releasees"), from any and all claims, liabilities, actions, demands and damages, whatsoever, in law or in equity, that Releasors may hereafter have in any manner relating directly or indirectly to Transmission initiated by a third party, including without limitation, any EFS-affiliate location, cardholder, or any claim arising out of or relating to actions taken by Releasees in accordance with or in reliance upon information or instructions provided by Releasor or any other third party. |
| Authorized Signature | |
| Print Name |
Check all that apply:
EFS Formats:| Standard Fuel (ocs056) | |
| Comma-delimited fuel (ocs058) | |
| Standard TransCheck (usr056) | |
| Truck stop data (tcs506) | |
| Truck stop prices (tcs.dat) |
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McLeod format (ocs056)
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Innovative format (ars122)
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Prophesy format (ocs058)
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Other
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Effective Date:
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| Upon completion email or fax to:
Questions call 866-841-9315 ext. 16776 |