SECURITY VIDEO REQUEST FORM (NON-LAW ENFORCEMENT AGENCY)

SECURITY VIDEO REQUEST FORM (NON-LAW ENFORCEMENT AGENCY)
When available, World Oil Corp. or its relevant subsidiary or affiliate (such entity, “World Oil”) may provide video security footage for the limited purpose of assisting you in your investigation. The video is proprietary and confidential to World Oil. You may not modify the video and/or images in any way, reproduce or publicly display, perform, distribute or otherwise use the video and/or images for any public or commercial purpose without World Oil’s express written consent. Any use of the video and/or images on any other website or networked computer environment for any purpose is strictly prohibited. If available, the video will be provided electronically via a cloud-based storage file. In cases where excessive video files are required, an external storage device may be used and a fee will be charged back to the requesting party. In such a situation, prior payment will be required from the requesting party before any available video footage is provided.

A valid subpoena is required and must be attached to this request form prior to any available security video files being distributed. File types accepted: PDF, Word, JPG, PNG.
Attach your subpoena here:*

Cancelof
Name of Requester (First and Last Name):*
Name of Company:
Mailing Address:*
Telephone Number:*
Email Address:*
example@example.com
TRANSACTION/INCIDENT INFORMATION:
Address of World Oil facility (Address, city, state, zip):*
Start date and time of transaction/incident (local time):*

MonthDayYear
Date
Hour MinutesAM/PM Option
End date and time of transaction/incident (local time):*

MonthDayYear
Date
Hour MinutesAM/PM Option
Camera views requested:*
Description of individuals/vehicles involved (if known):
Acknowledgement:

* By checking here, I affirm that the information provided herein is true and correct. I also understand that any unauthorized use of the video and/or images contained on the video security footage provided to me by World Oil may violate copyright, trademark and other laws. If I breach any of these Terms, my authorization to use the video and/or digital images will automatically terminate and I will immediately delete all electronic files and destroy any and all disc(s) and/or printed material containing video and/or images provided to me by World Oil.
Type Name*
Today's Date*

MonthDayYear
Date
Should be Empty: