Remote Access is a service of the Judicial Expense Fund of the Civil District Court for the Parish of Orleans. To subscribe to the CDC Remote Access Service, please supply the information requested below and return this form, together with your check made payable to the Judicial Expense Fund, to the Information Technology Center, Room 305. You will receive a username and a password via telephone or e-mail. Date: ______________ Name of Firm/Company: _______________________________________ Contact Person: ______________________________________________ Address: ____________________________________________________ City, State & Zip: _____________________________________________ Telephone #: ________________________________________________ Fax #: ______________________________________________________ E-mail Address: ______________________________________________ Type of business (circle one): Law Firm Title Company Bank Research Individual Other (please specify): ________________________________________ INFORMATION TECHNOLOGY CENTER USE ONLY Username: _________________ Password: ____________________ Fee @ time of signup: __________________