e-mail Append


	Client Portal

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e-mail Append
Account Code:

Please fill in the form as completely as possible. Fields in red are mandatory. We cannot process your order without them.

Dealership contact information:
Dealership name:
Dealer ID:
Telephone:
Address:

City:

State:

ZIP Code:

e-Append specifications:
Frequency:
Job type:
File type:
File format:	Other type:
Records submitted:
Broadcast signature:
Broadcast title:
Dealership URL:
Stop Quantity:
All Records
Stop Quantity:
Client File Provided (If file is not provided, please fill out our polling application.)
File name:

	Notes:
	Please record client file location (ftp site, email), and indicate any other information or requirements here.

Questions? email us at production@authenticom.com
Copyright © 2005 Authenticom. All rights reserved.
Revised: 3/18/2005