REQUEST INFO
 
Contact Information...    
Title  
     
First Name  
 
Last Name  
 
 
     
Company Name  
     
Type Of Company  
Lender
Tracker
Insurer
Other (explain)
Mailing Address  
City  
 
State  
     
Zip Code  
 
Please Note:
At this time, we are able to respond to Non-US inquiries via E-Mail only.

 
E-mail  
 
Web Site URL  
     
Daytime telephone  
    Extension
     
 
Question Fields...    
#1 How soon are you looking to implement a trading partner data exchange solution?
  Within 1 month
  Between 1 and 3 months
  Between 3 and 6 months
  Between 6 months and 1 year
  More than 1 year
     
#2 Which solutions have you already implemented? (multiple choice)
  Lienholder EDI
  Accounts Payable EDI
  EDI for other process
  X12
  XML
  Online Policy Access
  ACORD AL3
  Document Imaging
  Optical Character Recognition
  Data Entry Outsourcing
  Proprietary tape or file exchange
  Bulk mail of reports to trading partner
     
#3 Would you be interested in seeing a demo of Policy Requests Online?
  Yes
  No
     
#4 Would you like to see an online slideshow presentation describing our services?
  Yes
  No
     
#5 How did you hear about Insurance Trading Partners?
   
     
#6 Which services are you interested in?
  Policy Requests Online
  KeyIt
  EDI & XML Consulting
  CollectIt
     
#7 Other Questions or Comments...
         
     
 
   
     

 
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