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First Name Second Name Respondent Email Activation/Deactivation Date Total Users —Please choose an option—SingleMultiple Type of User Modification —Please choose an option—New UserDelete UserUser Feature ModificationUser Replacement Services Required Premium Enterprise User - Fixed SeatingPremium Enterprise User - Flexible SeatingK7 ConnectCall Recording, Storage, and PlaybackCall Center AgentCall Center SupervisorAnalytics ExtensionAnalytics Supervisor User Name Email Address Department/Groups —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial ServicesCreate new group Group Name Additional Information User Name Email Address Department/Groups —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial ServicesCreate new group Group Name Additional Information Group Name User Name Email Address Department/Groups —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial ServicesCreate new group Group Name Additional Information Group Name Existing User Name New User Name Email Address Department/Groups —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial ServicesCreate new group Group Name Additional Information Type of User Modification —Please choose an option—New UserDelete User Number of Accounts User Information Name Email Address Department/Group —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial Services Services Required —Please choose an option—Premium Enterprise User - Fixed SeatingPremium Enterprise User - Flexible SeatingK7 ConnectCall Recording, Storage, and PlaybackCall Center AgentCall Center SupervisorAnalytics ExtensionAnalytics Supervisor Additional Services Required Number of Accounts User Information Name Email Address Department/Group [select deptgrp include_blank "Mid America Cat Services" "Pure Claims" "Germania FIGA" "LIGA SFIC" "Western National" "HOA" "Nation wide" "LIGA" "Southern Oak Insurance" "Nautilus" "Frontline" "Kosovo FH" First Name [text* first-name akismet:author autocomplete:name] Second Name Respondent Email Activation/Deactivation Date Total Users —Please choose an option—SingleMultiple Type of User Modification —Please choose an option—New UserDelete UserUser Feature ModificationUser Replacement Services Required Premium Enterprise User - Fixed SeatingPremium Enterprise User - Flexible SeatingK7 ConnectCall Recording, Storage, and PlaybackCall Center AgentCall Center SupervisorAnalytics ExtensionAnalytics Supervisor User Name Email Address Department/Groups —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial ServicesCreate new group Group Name Additional Information User Name Email Address Department/Groups —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial ServicesCreate new group Group Name Additional Information Group Name User Name Email Address Department/Groups —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial ServicesCreate new group Group Name Additional Information Group Name Existing User Name New User Name Email Address Department/Groups —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial ServicesCreate new group Group Name Additional Information Type of User Modification —Please choose an option—New UserDelete User Number of Accounts User Information Name Email Address Department/Group —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial Services Services Required —Please choose an option—Premium Enterprise User - Fixed SeatingPremium Enterprise User - Flexible SeatingK7 ConnectCall Recording, Storage, and PlaybackCall Center AgentCall Center SupervisorAnalytics ExtensionAnalytics Supervisor Additional Services Required Number of Accounts User Information Name Email Address Department/Group —Please choose an option—Mid America Cat ServicesPure ClaimsGermania FIGALIGA SFICWestern NationalHOANation wideLIGASouthern Oak InsuranceNautilusFrontlineKosovo FHKosovo CCLCPICFarm Bureau Financial Services Δ
