| Contact Information: |
|
| Lender Company Name |
______________________________ |
| Lender Tax Identification Number |
______________________________ |
| Lender Technical Contact Name |
______________________________ |
| Lender Technical Contact Telephone |
______________________________ |
| Lender Business Contact Name |
______________________________ |
| Lender Business Contact Telephone |
______________________________ |
| |
|
| Electronic Data Interchange (EDI) |
|
| Do you use Electronic Data Interchange (EDI)? |
Yes ____ No ____ |
| Have you purchased an EDI translator? |
Yes ____ No ____ |
| If you have not purchased an EDI translator will you be writing your own program? |
Yes ____ No ____ |
| Are you currently doing EDI with other insurance companies? |
Yes ____ No ____ |
Can you return a 997 Functional Acknowledgement each time an EDI file is sent (within two business days)? |
Yes ____ No ____ |
| |
|
| State Farm Connectivity (please choose one) |
|
1. Preferred Method is File Transfer Protocol (FTP) over the internet with encryption (i.e. PGP or GNU) sending to and receiving from the vendor’s server |
|
| 2. FTP over the internet with encryption (i.e. PGP or GNU) sending to and receiving from a State Farm server. |
|
| 3. Virtual Private Network (VPN) over the internet using standard ports. |
|
| 4. Value Added Network (VAN) mailbox. |
|
