Business Partner Registration, Submitted Screen

<H2 class=form>Description</H2>
<BLOCKQUOTE>This screen is part of the Business Partner Registration subsystem and is used view the Submitted Business Partner Registrations. The Business Partner Registration screen provides part of the Business Partner functionality and is accessed from clicking the Business Partner name link under the Submitted column on the Business Partner by Status screen or from clicking the Business Partner name link under the Business Partner column on the Submitted Business Partners screen. The Business Partner Registration screen can be accessed by an authorized user group.
<P></P></BLOCKQUOTE><BR>
<H2 class=form>Fields</H2>
<BLOCKQUOTE>
<TABLE border=1>
<TBODY>
<TR vAlign=top>
<TD width=109><B><FONT face=Arial size=2>Field Name</FONT></B></TD>
<TD width=150>
<DIV align=center><B><FONT face=Arial size=2>State</FONT></B></DIV></TD>
<TD width=372><B><FONT face=Arial size=2>Description</FONT></B></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Business Partner Status</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Protected – Read Only</FONT></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Business Partner Status field displays the status of the registration. </FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Date Submitted</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Protected – Read Only</FONT></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Date Submitted field displays the date the registration was submitted to PENNDOT.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Received Paper Form</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required</FONT></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Received Paper Form field is used to check if PENNDOT has received the paper registration form. This field is required if the registration status needs to change to a pending status.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><IMG height=1 alt="" src="/icons/ecblank.gif" width=1 border=0></TD>
<TD width=150><IMG height=1 alt="" src="/icons/ecblank.gif" width=1 border=0></TD>
<TD width=372><B><FONT face=Arial size=2>The following fields will be displayed in the General Info tab.</FONT></B></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Business Partner Name</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Business Partner Name field is used to enter the name of the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Federal ID Number (FID)</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Protected – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Federal ID Number (FID) field is used to enter the FID of the business. This is a nine (9) digit field and is required.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Phone Number</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Phone Number field is used to enter the phone number of the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Ext </FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Ext field is used to enter the phone number extension of the business. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Fax Number</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Fax Number field is used to enter the fax number of the business. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Email</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Email field is used to enter the email address of the business. This email address will be used to send the approval or rejection. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Doing Business As</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Protected – Pre-Populated</FONT></DIV></TD>
<TD width=372><FONT face=Arial size=2>The list of available Business Partner types and the business partner types the Business Partner types is requesting approval for.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><IMG height=1 alt="" src="/icons/ecblank.gif" width=1 border=0></TD>
<TD width=150><IMG height=1 alt="" src="/icons/ecblank.gif" width=1 border=0></TD>
<TD width=372><B><FONT face=Arial size=2>The following fields will be displayed in the Legal Address tab.</FONT></B></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Address 1</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Address 1 field is used to enter the legal address of the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Address 2</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Address 2 field is used to enter another address line of the business. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Address 3</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Address 3 field is used to enter another address line of the business. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>City</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The City field is used to enter the city of the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>State</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The State field is used to enter the state of the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Zip Code</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Zip code field is used to enter the zip code of the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Zip +4</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Zip+4 field is used to enter the additional four digits of the businesses zip code. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><IMG height=1 alt="" src="/icons/ecblank.gif" width=1 border=0></TD>
<TD width=150><IMG height=1 alt="" src="/icons/ecblank.gif" width=1 border=0></TD>
<TD width=372><B><FONT face=Arial size=2>The following fields will be displayed in the Mailing Address tab.</FONT></B></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Address 1</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Address 1 field is used to enter the legal address of the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Address 2</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Address 2 field is used to enter another address line of the business. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Address 3</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Address 3 field is used to enter another address line of the business. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>City</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The City field is used to enter the city of the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>State</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The State field is used to enter the state of the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Zip Code</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Zip code field is used to enter the zip code of the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Zip +4</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Zip+4 field is used to enter the additional four digits of the businesses zip code. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><IMG height=1 alt="" src="/icons/ecblank.gif" width=1 border=0></TD>
<TD width=150><IMG height=1 alt="" src="/icons/ecblank.gif" width=1 border=0></TD>
<TD width=372><B><FONT face=Arial size=2>The following fields will be displayed in the Administrator Info tab.</FONT></B></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>First Name</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The First Name field is used to enter the first name of the businesses administrator. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Middle Initial</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Middle Initial field is used to enter the middle initial of the businesses administrator. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Last Name</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Last Name field is used to enter the last name of the businesses administrator. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Phone Number</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Phone Number field is used to enter the phone number of the businesses administrator. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Ext</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Ext field is used to enter the extension number of the businesses administrator. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Fax Number</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Fax Number field is used to enter the fax number of the businesses administrator. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Email</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Email field is used to enter the email address of the businesses administrator. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><IMG height=1 alt="" src="/icons/ecblank.gif" width=1 border=0></TD>
<TD width=150><IMG height=1 alt="" src="/icons/ecblank.gif" width=1 border=0></TD>
<TD width=372><B><FONT face=Arial size=2>The following fields will be displayed in the Authorized Signatory tab.</FONT></B></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Signatory Name</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Signatory Name field is used to enter the name of the authorized signatory for the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Signatory Title</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Signatory Title field is used to enter the title of the authorized signatory for the business. This is a required field. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Signatory Phone Number</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Signatory Phone Number field is used to enter the phone number of the signatory. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Ext</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Optional – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Ext field is used to enter the extension number of the signatory. This field may be changed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=109><FONT face=Arial size=2>Attested by Name</FONT></TD>
<TD width=150>
<DIV align=center><FONT face=Arial size=2>Editable – Required – </FONT>
<P><FONT face=Arial size=2>Pre-Populated</FONT></P></DIV></TD>
<TD width=372><FONT face=Arial size=2>The Attested by Name field is used to enter the name of the person who attested the registration. This is a required field. This field may be changed in edit mode.</FONT></TD></TR></TBODY></TABLE></BLOCKQUOTE><BR>
<H2 class=form>Actions</H2>
<BLOCKQUOTE>
<P><FONT face=Helvetica size=2></FONT>
<TABLE border=1>
<TBODY>
<TR vAlign=top>
<TD width=138><B><FONT face=Arial size=2>Action</FONT></B></TD>
<TD width=492><B><FONT face=Arial size=2>Description</FONT></B></TD></TR>
<TR vAlign=top>
<TD width=138><FONT face=Arial size=2>Back button clicked</FONT></TD>
<TD width=492><FONT face=Arial size=2>When the user clicks the Back button, the previous page will be displayed.</FONT></TD></TR>
<TR vAlign=top>
<TD width=138><FONT face=Arial size=2>Edit button clicked</FONT></TD>
<TD width=492><FONT face=Arial size=2>When the user clicks the Edit button, the page will be displayed in edit mode.</FONT></TD></TR>
<TR vAlign=top>
<TD width=138><FONT face=Arial size=2>Save &amp; Exit button clicked</FONT></TD>
<TD width=492><FONT face=Arial size=2>When the user clicks the Save &amp; Exit button, the page will be saved and submitted.</FONT></TD></TR>
<TR vAlign=top>
<TD width=138><FONT face=Arial size=2>Click on General Info tab</FONT></TD>
<TD width=492><FONT face=Arial size=2>When the user clicks on the General Info, it will bring up fields to enter the Business Partner information.</FONT></TD></TR>
<TR vAlign=top>
<TD width=138><FONT face=Arial size=2>Click on Legal Address tab</FONT></TD>
<TD width=492><FONT face=Arial size=2>When the user clicks on the Legal Address, it will bring up fields to enter the Legal Address.</FONT></TD></TR>
<TR vAlign=top>
<TD width=138><FONT face=Arial size=2>Click on Mailing Address tab</FONT></TD>
<TD width=492><FONT face=Arial size=2>When the user clicks on the Mailing Address, it will bring up fields to enter the Mailing Address.</FONT></TD></TR>
<TR vAlign=top>
<TD width=138><FONT face=Arial size=2>Click on Administrator Information tab</FONT></TD>
<TD width=492><FONT face=Arial size=2>When the user clicks on Administrator Information, it will bring up fields to enter the Administrator Information.</FONT></TD></TR>
<TR vAlign=top>
<TD width=138><FONT face=Arial size=2>Click on Authorized Signatory tab</FONT></TD>
<TD width=492><FONT face=Arial size=2>When the user clicks on the Authorized Signatory, it will bring up fields to enter the Authorized Signatory information.</FONT></TD></TR></TBODY></TABLE></P></BLOCKQUOTE>

Description

This screen is part of the Business Partner Registration subsystem and is used view the Submitted Business Partner Registrations. The Business Partner Registration screen provides part of the Business Partner functionality and is accessed from clicking the Business Partner name link under the Submitted column on the Business Partner by Status screen or from clicking the Business Partner name link under the Business Partner column on the Submitted Business Partners screen. The Business Partner Registration screen can be accessed by an authorized user group.


Fields

Field Name
State
Description
Business Partner Status
Protected – Read Only
The Business Partner Status field displays the status of the registration.
Date Submitted
Protected – Read Only
The Date Submitted field displays the date the registration was submitted to PENNDOT.
Received Paper Form
Editable – Required
The Received Paper Form field is used to check if PENNDOT has received the paper registration form. This field is required if the registration status needs to change to a pending status.
The following fields will be displayed in the General Info tab.
Business Partner Name
Editable – Required –

Pre-Populated

The Business Partner Name field is used to enter the name of the business. This is a required field. This field may be changed in edit mode.
Federal ID Number (FID)
Protected – Required –

Pre-Populated

The Federal ID Number (FID) field is used to enter the FID of the business. This is a nine (9) digit field and is required.
Phone Number
Editable – Required –

Pre-Populated

The Phone Number field is used to enter the phone number of the business. This is a required field. This field may be changed in edit mode.
Ext
Editable – Optional –

Pre-Populated

The Ext field is used to enter the phone number extension of the business. This field may be changed in edit mode.
Fax Number
Editable – Optional –

Pre-Populated

The Fax Number field is used to enter the fax number of the business. This field may be changed in edit mode.
Email
Editable – Required –

Pre-Populated

The Email field is used to enter the email address of the business. This email address will be used to send the approval or rejection. This field may be changed in edit mode.
Doing Business As
Protected – Pre-Populated
The list of available Business Partner types and the business partner types the Business Partner types is requesting approval for.
The following fields will be displayed in the Legal Address tab.
Address 1
Editable – Required –

Pre-Populated

The Address 1 field is used to enter the legal address of the business. This is a required field. This field may be changed in edit mode.
Address 2
Editable – Optional –

Pre-Populated

The Address 2 field is used to enter another address line of the business. This field may be changed in edit mode.
Address 3
Editable – Optional –

Pre-Populated

The Address 3 field is used to enter another address line of the business. This field may be changed in edit mode.
City
Editable – Required –

Pre-Populated

The City field is used to enter the city of the business. This is a required field. This field may be changed in edit mode.
State
Editable – Required –

Pre-Populated

The State field is used to enter the state of the business. This is a required field. This field may be changed in edit mode.
Zip Code
Editable – Required –

Pre-Populated

The Zip code field is used to enter the zip code of the business. This is a required field. This field may be changed in edit mode.
Zip +4
Editable – Optional –

Pre-Populated

The Zip+4 field is used to enter the additional four digits of the businesses zip code. This field may be changed in edit mode.
The following fields will be displayed in the Mailing Address tab.
Address 1
Editable – Required –

Pre-Populated

The Address 1 field is used to enter the legal address of the business. This is a required field. This field may be changed in edit mode.
Address 2
Editable – Optional –

Pre-Populated

The Address 2 field is used to enter another address line of the business. This field may be changed in edit mode.
Address 3
Editable – Optional –

Pre-Populated

The Address 3 field is used to enter another address line of the business. This field may be changed in edit mode.
City
Editable – Required –

Pre-Populated

The City field is used to enter the city of the business. This is a required field. This field may be changed in edit mode.
State
Editable – Required –

Pre-Populated

The State field is used to enter the state of the business. This is a required field. This field may be changed in edit mode.
Zip Code
Editable – Required –

Pre-Populated

The Zip code field is used to enter the zip code of the business. This is a required field. This field may be changed in edit mode.
Zip +4
Editable – Optional –

Pre-Populated

The Zip+4 field is used to enter the additional four digits of the businesses zip code. This field may be changed in edit mode.
The following fields will be displayed in the Administrator Info tab.
First Name
Editable – Required –

Pre-Populated

The First Name field is used to enter the first name of the businesses administrator. This is a required field. This field may be changed in edit mode.
Middle Initial
Editable – Optional –

Pre-Populated

The Middle Initial field is used to enter the middle initial of the businesses administrator. This field may be changed in edit mode.
Last Name
Editable – Required –

Pre-Populated

The Last Name field is used to enter the last name of the businesses administrator. This field may be changed in edit mode.
Phone Number
Editable – Required –

Pre-Populated

The Phone Number field is used to enter the phone number of the businesses administrator. This field may be changed in edit mode.
Ext
Editable – Optional –

Pre-Populated

The Ext field is used to enter the extension number of the businesses administrator. This field may be changed in edit mode.
Fax Number
Editable – Optional –

Pre-Populated

The Fax Number field is used to enter the fax number of the businesses administrator. This field may be changed in edit mode.
Email
Editable – Required –

Pre-Populated

The Email field is used to enter the email address of the businesses administrator. This is a required field. This field may be changed in edit mode.
The following fields will be displayed in the Authorized Signatory tab.
Signatory Name
Editable – Required –

Pre-Populated

The Signatory Name field is used to enter the name of the authorized signatory for the business. This is a required field. This field may be changed in edit mode.
Signatory Title
Editable – Required –

Pre-Populated

The Signatory Title field is used to enter the title of the authorized signatory for the business. This is a required field. This field may be changed in edit mode.
Signatory Phone Number
Editable – Optional –

Pre-Populated

The Signatory Phone Number field is used to enter the phone number of the signatory. This field may be changed in edit mode.
Ext
Editable – Optional –

Pre-Populated

The Ext field is used to enter the extension number of the signatory. This field may be changed in edit mode.
Attested by Name
Editable – Required –

Pre-Populated

The Attested by Name field is used to enter the name of the person who attested the registration. This is a required field. This field may be changed in edit mode.

Actions

Action Description
Back button clicked When the user clicks the Back button, the previous page will be displayed.
Edit button clicked When the user clicks the Edit button, the page will be displayed in edit mode.
Save & Exit button clicked When the user clicks the Save & Exit button, the page will be saved and submitted.
Click on General Info tab When the user clicks on the General Info, it will bring up fields to enter the Business Partner information.
Click on Legal Address tab When the user clicks on the Legal Address, it will bring up fields to enter the Legal Address.
Click on Mailing Address tab When the user clicks on the Mailing Address, it will bring up fields to enter the Mailing Address.
Click on Administrator Information tab When the user clicks on Administrator Information, it will bring up fields to enter the Administrator Information.
Click on Authorized Signatory tab When the user clicks on the Authorized Signatory, it will bring up fields to enter the Authorized Signatory information.



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Created by
Joseph D Howe/PennDOT
on 03/16/2005 at 10:48:56 AM