In order to expedite shipping and installation of your Positive Pay Application please complete this questionnaire.
 Should you need assistance, please call inFORM Decisions. Additionally, please fax back the bank’s required file 
 format for positive pay and login and password information for the testing portion of the transmission. 
 The bank should be able to supply this information for you.
 
                                           Bank Information

 Bank Name:__________________              Contact Name for file format:_____________________         Voice Phone:_____________
                                           Contact Name for file transmission:_______________         Voice Phone:_____________ 

Do you currently have a Bisync Modem (Y/N)? ______ Will the modem be used exclusively for bank transmissions (Y/N)? ___
  Test Transmission number:_______________            Test Baud Rate:_______
  Production transmission number:__________           Production Baud Rate:_______

Does the bank require the file to be sent via ftp?  ______
  FTPS? ____     SFTP? ____  

  Schedule date for implementing Positive Pay:____/____/____
  Is a prescheduled time required for sending file transmission (Y/N)? ______ Scheduled Transmission Time: ____________
  Is a fax of a transmission data required (Y/N)? _____

                                                       Company Information

  Company Technical Contact: ________________ Voice Phone: ________________
  Company Financial Contact: ________________ Voice Phone: ________________
  InFORM Decisions version : ________________ OS/400 ver : ________________

  What accounting software is in use on your AS/400? ________________
  How many bank accounts will be used for reporting Positive Pay Information? _____

  Account Number                  Company Number Division Number                GL Number
____________________             _______________ _______________              ______________________________________________
____________________             _______________ _______________              ______________________________________________
____________________             _______________ _______________              ______________________________________________
____________________             _______________ _______________              ______________________________________________

  Will you be transmitted cancelled and/or voided check information to the bank (Y/N)? ____
  Will you be expecting or does the bank offer a check reconciliation file (Y/N)? _____

  Please include any other information or questions that you have about Positive Pay Implementation in the 
  space provided below: