AT&T E9-1-1DB Access Request
Must accompany the E9-1-1 Information Manager Limited Use Agreement/Nondisclosure Agreement
USER INFORMATION (E9-1-1 Agency Use Page)
Complete sections highlighted in blue only
{Handwritten and/or incomplete forms will not be accepted.}
Choose State(s): Click to Select:
Current User ID:
(If converting to IM)
County name:
Your Name:
Agency Tax ID:
Employed by:
Department:
Title:
Telephone(s):
Business Address:
Ofc.
Cell:
Fax:
Street 1:
Street 2:
City, State:
ZIP+4
Other:
eMail Address:
Specify Requested User Access Levels
MSAG Queries Yes
No
MSAG Submissions Yes
No
ANI/ALI Reports/Audits/Queries Yes
No
PSAP Reports Yes
No
Permanent/Temporary User Permanent
Temporary
(Expiration date:
[mm/dd/yy])
County/PSAPList all Counties & PSAPs governed by your Agency
List all Counties governed by
List all PSAPs governed by your List any Cities governed by your
your agency
agency
agency outside of your county
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1)
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5)
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If additional space is needed please include the additional information on the email with the form(s).
USER’S SECURITY RESPONSIBILITIES
Upon signing this form and using this userid, I acknowledge that I have read, understand and will comply with my security responsibilities as
described in the AT&T E9-1-1DB Non-Disclosure Agreement. The system files, programs and electronic mail I access are subject to audit by
AT&T at any time.
User Signature:
Date:
eMail completed form to: [email protected] (This document must be received with the Non-Disclosure
Agreement.)
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AT&T E9-1-1DB Access Request
Must accompany the E9-1-1 Information Manager Limited Use Agreement/Nondisclosure Agreement
**The following pages to be Completed by AT&T DOC Personnel**
Select User Type
Click to Select:
Select Activity
Click to Select:
Current User-ID if Converting to IM:
AT&T Employee Responsible for Request
Employee: Click to Select
Address: Click to Select:
Telephone: Click to Select
User ID: Click to Select
Date:
e-Mail: Click to Select
Package Information (Organization)
Permissions
Global View Name
State:
Assign an Organization Name
Organization Type Click to Select
Parent ROOT
Package Name MUNI FULL ACCESS
Click to Select
TN View Click to Select
Click to Select
MSAG View Click to Select
Click to Select
MSAG CR View Click to Select
Click to Select
ALI Audit&Discrepancy Report Click to Select
General Reports
PSAP ID(s):
(may obtain from mm/ask PSAP reports)
MSAG Yes
PSAP Yes
Wireless1 Yes
Wireless2 Yes
Service Order Metrics Reports
TN Err Resolution:
SUM Yes DET Yes
Processing Statistics Overall Yes
Outstanding TN Err:
SUM Yes DET Yes
Company ID’s for Report All
1. New user in existing IM Organization? 2. Is user converting from MM/ASK to IM?
Yes
Leave below fields blank
Yes
Provide MM/ASK MUNI-ID:
, complete County/FIPS & ST fields.
No
See question 2
No
Complete all fields below.
GLOBAL VIEW
COMMUNITY
County/FIPS
ST
AlternateCounty/FIPS AlternateCounty/FIPS
Additional space provided on next page/ Check here
if continued
NON-GLOBAL VIEW
NPA
NNX
Community
County FIPS ST
Additional space provided on next page. Check here
Variations from Defaults
Maximum number of records per query
Maximum number of records per report
Maximum number of report requests per day [5]
Hide non-published TNs
Hide all customer information
Hide option to show TN detail
Hide option to list TN summary
Hide option to list TN fallout
Hide option to calculate TN count
Timeout period to logoff (min) [ 30]
EXCH
TN
Allow Access for:
MSAG MSAG-CR ALI-DR
if continued
25,000
4,000
5
YES
NO
NO
NO
NO
NO
30
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AT&T E9-1-1DB Access Request
Must accompany the E9-1-1 Information Manager Limited Use Agreement/Nondisclosure Agreement
GLOBAL VIEW
COMMUNITY
County/FIPS
State
AlternateCounty/FIPS
AlternateCount
y/FIPS
NON-GLOBAL VIEW
NPA
NNX
Community
County FIPS
ST
EXCH
TN
Allow Access for:
MSAG MSAG-CR ALI-DR
Company ID’s
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AT&T E9-1-1DB Access Request
Must accompany the E9-1-1 Information Manager Limited Use Agreement/Nondisclosure Agreement
USER-ID Request Completion Information
To be completed by AT&T E9-1-1DB Administration
New MUNI ID:
New PSAP ID:
New USERID:
Security Admin APPROVAL
Name: Senovia Gsell
Title: Systems Analyst-E9-1-1
Date:
If Other:
Name
Address:
Title:
e-Mailed completed form with MUNI-ID/PSAP-ID/USER-ID back to DOC Manger on:
(mm/dd/yyyy)
Completed by:
Name:
Date:
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