Client Care Support - Client Forms

EDS*ELIT VAN Enrollment Form

Please allow up to 5 business days for your new EDS*ELIT VAN mailbox to be registered, configured and ready for use. Failure to complete the EDS*ELIT VAN Enrolment form in its entirety may result in a delay in mailbox setup.

If you have any questions, please contact busexch.ca.elit@eds.com

Async	Non-Secure FTP	Secure FTP		ANX FTP
HTTPS	URL		Port
VPN Tunnel	URL		Port
AS2	URL		Port
	Certificate File Upload

Attach AS2 Digital Certificate

Indicates a required field

Company Information:

Company Name:
Contact First Name:
Contact Last Name:
Company Email Address:
Company Phone #:
Company Fax #:
Address:
City/Town:
Province/State:
Zip/Postal Code:

Invoicing Information: (Check to use Company Information: )

Contact First Name:
Contact Last Name:
Invoicing Contact Email Address:
Invoicing Contact Phone #:
Invoicing Contact Fax #:
Invoicing Address:
City/Town:
Province/State:
Zip/Postal Code:

I.D. Information:

Test ISA Qualifier:
Test ISA ID:
Production ISA Qualifier:
Production ISA ID:

Trading Partner Information:

Trading Partner Name:
Contact Name:
Contact Phone #:
Contact Fax #:
Test ISA Qualifier:
Test ISA ID:
Production ISA Qualifier:
Production ISA ID:
VAN to interconnect with:

		Business Exchange Services Client Care Support
		Home		Client Programs		Trading Partner Solutions		Client Care Support		Channel Partners