APCC SERVICES
Internet Access to Dial Around Quarterly Reports
For the security of your APCC Services dial around quarterly reports, please select your “User ID,” “Password” and “Authentication Code.”
Company Name ____________________________________________
Account Number ______________________ (APCC Services Dial Around Account)
1. Please choose a “User ID” (4 to 6 digits MAXIMUM - alpha or numeric or combination):
££££££
2. Please choose a “Password” (4 to 6 digits MAXIMUM - alpha or numeric or combination):
££££££
Your User ID and Password will be necessary every time you log on to the web server.
3. Please choose an “Authentication Code” (4 to 15 characters – alpha or numeric or combination):
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Your Authentication Code will be used by APCC Services for verification purposes.
If you forget your Password or User ID, call APCC Services and be prepared to
give us this Authentication Code.
4. Please indicate your EMAIL ADDRESS: _______________________________
APCC Services will activate the User ID and Password you have selected 24 business hours after APCC Services’ receipt of this application. No confirmation of password activation will be sent.
KEEP A COPY OF THIS APPLICATION IN YOUR FILES!
______________________________________________________________________
Signature of Company Owner or President
______________________________________________________________________
Print Name
A signed copy of this application must be returned to APCC Services via fax or mail.
Fax to: (703) 739-1324 Attn: Dial Around Department
Or Mail to: 625 Slaters Lane STE 104 Alexandria, VA 22314