Registering for: (Please select all that apply)

	AS1
	AS3
	AS4
	ebMS 2.0

Company and Product Information (All fields are required.)

Please select the one that best fits your situation:

	Our product has never been certified. (must complete In-the-queue (ITQ), Insitu Enabled, Interop - does not apply to ebMS 2.0 or AS4)
	Our product participated in the last Interop. (must complete Interop)
	We have certified before, but not in the last Interop. (must complete ITQ, Interop)

Please note that if you did not certify in the last AS2 Interop, you will have to undergo AS2 ITQ testing. If you have not enabled your product for InSitu, you will also have to participate in InSitu Enable. We will send an email with further information after you complete your registration.

Is the product you are registering InSitu® enabled? (does not apply to ebMS 2.0 or AS4)
YES
NO
Does not apply

Which customer(s) are requiring certification?

Previous (Backward) Version (does not apply to ebMS 2.0 or AS4)
If you certified your product in the last Interop and this is a newer version, you are allowed to register your previous version for free. Do you want to register your previous version?

	YES What is the Product Name and Version number of your previous version?
	NO
	Does not apply

Product Availability
Products tested are required to be available on the market at most 90 days after the test concludes.

Product Commercial Status: (check one)

Available Now
30 days after test concludes
60 days after test concludes
90 days after test concludes

Third Party Toolkits

The following information assists us in preparing for the test. This information is for DGI internal use only and is not made public.

*Product Functions Supported: (select all that apply): (DOES NOT APPLY TO AS4)

SMTP HTTP HTTP/S FTP

*S/Mime Toolkit: (select all that apply):

Entrust RSA Java IAIK Other
Specify Other:

Administrative Contact (All fields are required.)

This person is the primary point of contact and is responsible for the overall relationship and commitment of resources.

*First Name:
*Last Name:
*Title:
*Address:
*Phone:
*Fax:
*eMail:

Accounts Payable Contact

If specified invoices will be directed here, otherwise they will be sent to the administrative contact.

Check here if the Accounts Payable contact is the same as the Administrative Contact

Name and Title:
Address:
Phone:
Fax:
eMail:

Press Contact

If specified invoices will be directed here, otherwise they will be sent to the administrative contact.

Check here if the Press contact is the same as the Administrative Contact

Name and Title:
Address:
Phone:
Fax:
eMail:

Technical Contact

This person is required to operate and support your product during the execution of the interoperability test.

Check here if the Technical contact is the same as the Administrative Contact

Technical Contact 1
Name and Title:
Phone:
eMail:
Technical Contact 2
Name and Title:
Phone:
eMail:
Technical Contact 3
Name and Title:
Phone:
eMail:
Technical Contact 4
Name and Title:
Phone:
eMail:

*Please type the word "orange" here: (lower case, no quotes)