Advantage Lien Protection, LLC.

Enrollment Application

1. Company Information

Name/dba*

FEIN*

Mail Address*

City*

State*

Zip*

Physical Address*

Zip

Phone*

Fax

Home

State of Registry*

License Number and Name

Principal State(s) of Business*

Usual Job Tier

Trade(s) or Profession*

Projects Value Range: Low

High

Projects per Year

Number of Employees*

Entity Type* Other

2. Contact Information

First Name*

Last Name*

Title*

Cell Phone

Alternate Contact

Alternate Email

Additional Parties

Best Time

3. Select Your Service Plan

Service Plan	FAX Orders & Updates	Online Order	Online Reminder Report	E-mail Reminder Report	E-Lien Alert	Date- Watcher	Doc Builder	Fee
Basic Service								Included
Premium								+ $500 / yr

(Subcontractors) Should we send copy of Notices to your hiring party?

4. Trade or Professional Memberships

5. Charges and Invoicing

There is a One-time new client origination fee of $200 plus any charges that may apply to the service plan you select. Add fee for Service Order(s) you submit now. (Request more information for details.)
You will be given an opportunity to verify your information and the amount due before any charges are incurred.

Payment Options
Solution Graphics

After clicking "Send" below, you may choose to pay by credit card now or pay by check.

After sending Enrollment form, use Service Order, located on Construction Services page.

Prepaid WI Prelien Plan

6. Web Access

Create for yourself a username and password for access to your online account features (all lowercase, no spaces).

User name:
Password:

7. This application for enrollment subject to terms of Service Agreement and is not a contract until and only if accepted in writing by both parties. Limited offer.

Authorized Representative*:

Service subject to ALP Service Agreement.

ALL fields must be filled in to process your request

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