Electronic Submission Service ApplicationOn behalf of the organization specified below, I request authorization to submit real estate documents for the purposes of official recording in any county or jurisdiction participating in the ILR Electronic Submission Service. By submitting this application to become an authorized user of the Electronic Submission Service, I certify that I have reviewed the Electronic Service Terms of Use and Privacy policies published at the following web address: https://iowalandrecords.org/esubmission. I agree to abide by the terms and conditions specified therein.Please provide the following information. All information is required. Incomplete applications will not be processed.Organization type (Check a Box)* Abstract Co. Attorney Bank City Government Credit Union Federal Government Media Mortgage Co. Realtor State Government Surveyor Other (specify)Your Organization Type*How did you hear about e-submission with Iowa Land Records?* Direct Mailing Social Media County Recorder Advertisement Colleague Tradeshow Other (specify)Referral Source: OtherPromo Code:Organization InformationOrganization Name:*Address:* Street Address 1: Street Addres 2: City State ZIP Phone Number:*Fax Number:Organization Administrator InformationRequested User Name:*Name* First Name Last Name Email* Payment MethodPlease let us know how you will pay for your electronic submissions. The Iowa Land Records team will work with you to set up your payment account.Payment Method*We will use a credit card for paymentWe will use a bank account for paymentE-Submission Validation InformationPlease provide an example of a document you have recorded in Iowa by specifying the reference number of the recorded document and the county in which the document was recorded.Iowa County:Book & Page or Document Reference Number:Date of Recording: MM slash DD slash YYYY AgreementI represent and warrant that on behalf of the organization specified above I have the right, power and authority to enter into and perform the obligations under this agreement. I have taken all requisite action (corporate, statutory, or otherwise to approve execution, delivery and performance of this agreement, and this Agreement constitutes a legal, valid and binding obligation of the applicant, enforceable in accordance with its terms. I further agree to the Electronic Submission Service Terms of Use policy and Privacy policy.E-Signature*Date:* MM slash DD slash YYYY
