First Name
Second Name

Respondent Email

Activation/Deactivation Date

Total Users —Please choose an option—SingleMultiple

[group single-user]
Type of User Modification —Please choose an option—New UserDelete UserUser Feature ModificationUser Replacement

[group newuser]
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 createnewgroup]
Group Name
[/group]
Additional Information
[/group]

[group deleteuser]
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 createnewgroup2]
Group Name
[/group]
Additional Information
[/group]

[group userfeaturemodification]
Group Name
[/group]

[group userreplacement]
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 createnewgroup3]
Group Name
[/group]
Additional Information
[/group]

[/group]

[group multiple-users]
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 createnewgroup4]
Group Name
[/group]
Additional Information

Type of User Modification —Please choose an option—New UserDelete User
[group group-mulitplenewuser]
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
[/group]

[group group-mulitpledeleteuser]
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

[group single-user]
Type of User Modification —Please choose an option—New UserDelete UserUser Feature ModificationUser Replacement

[group newuser]
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 createnewgroup]
Group Name
[/group]
Additional Information
[/group]

[group deleteuser]
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 createnewgroup2]
Group Name
[/group]
Additional Information
[/group]

[group userfeaturemodification]
Group Name
[/group]

[group userreplacement]
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 createnewgroup3]
Group Name
[/group]
Additional Information
[/group]

[/group]

[group multiple-users]
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 createnewgroup4]
Group Name
[/group]
Additional Information

Type of User Modification —Please choose an option—New UserDelete User
[group group-mulitplenewuser]
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
[/group]

[group group-mulitpledeleteuser]
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
[/group]

[/group]