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Business Partner Site Web Access Request Form  
The purpose of a Business Partner Site Web Account is to grant authorized personnel (i.e. General Manager, Owner, Service Manager) access to the Xerox Business Partner Site, where our Authorized Service Providers can view Service Provider reference materials such as our ASP Reference Manual, Technical Newsletters and other references documents. Additionally, we can grant access to authorized administrative personnel to view these reference materials as well as place part orders and file labor reimbursement requests on behalf of your organization and your certified technicians. This service strategy takes administrative tasks away from the technician who can focus their efforts on servicing your customers.

Administrative personnel will have the ability to order training materials and once your company has one product certification, may order parts and submit claims on behalf of certified technicians.

Please allow 1-2 business days for your information to be processed. You will be notified via e-mail with your username and password.

If you have any questions, please call 1-(800)-249-0347 option 3, 3, 4. One of our Partner Alliances Specialists can help you with any of your concerns.

All fields marked with * are required to process the request

Person Information
Contact Name*
Provide the first and last name of
the person you are requesting
access for.
Job/Title Responsibility*
Check all that apply 		Admin
Technician
Manager
E-mail Address*
Provide the e-mail address of the
person you are requesting access
for.
Contact Phone*
Provide the contact phone of the
person you are requesting access
for.
Company Information
Legal Company Name*
Doing Business As (DBA)

Primary Billing Address*
PO boxes are accepted. 		Address Line 1

Address Line 2

City                      State/Prov   Zip/Postal Code
   

Primary Shipping Address
If different than the Primary Billing
Address.


Physical street address only.
No PO Boxes. 		Address Line 1

Address Line 2

City                      State/Prov   Zip/Postal Code
   
Technician Information
Technician IDs*
Please list the Technician
Certification Number, as
well as name of technician
(i.e., 72300 – Andy Evans).

**Please note**ADMIN’s will have the ability to submit claims and order parts on behalf of certified technicians only
  

    

    

    

    
Are you a certified
technician also?*
 Yes
No
If Yes, what is your TCN?
Form Submitted By:
If different than person access is
being requested for.
 
Please enter the displayed code*
 
To complete this application 1098