EDI Trading Partners Application

* Required Fields

Company Information
Company:*
Name:*
Address:*
City:*		State:*	Zip:*

Contact: (Please supply toll free numbers when available.)
EDI Technical:
Orders: Name:	Phone:	Email:
Invoices: Name:	Phone:	Email:
Logistics/Transportation: Name:	Phone:	Email:
EFT: Name:	Phone:	Email:
Value Added Network:

Sender/Receiver IDs:
	Production	Test
ISA Qualifier:
ISA Sender/Receiver ID:
GS Sender/Receiver ID:
When will you be available to test?	/ / (mm/dd/yyyy)
Expiration Date:	/ / (mm/dd/yyyy)

Documents & Versions:
What documents and versions does your organization support? Are you in production with these? If not, when?
Document(s)	Version	Production	If no, when?
214 – Shipment Status		Yes No
810 – Invoice		Yes No
820 – Remittance Advice		Yes No
850 – Purchase Order		Yes No
852 – Product Activity Data		Yes No
856 – Shipment Notification		Yes No
860 – PO Change		Yes No
861 – Receiving Paid		Yes No
997 – Acknowledgment		Yes No

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