Part A - Carrier Information

Please complete the required Carrier information.

Three digit Carrier Code:

Carrier Legal Name:

Trade Name (DBA):

Which tool administrator(s) are you re-designating? (Select at least one)

My ARC
DRS

* Complete the applicable sections of Part B for the applications selected above.

Part B1 - My ARC

My ARC Primary Administrator will perform the My ARC administrative functions for your organization and have the following capabilities, including, without limitation:

• View user accounts across your entire organization
• Create and delete user accounts
• Grant and revoke access to My ARC and to ARC Tools as they become available via My ARC (e.g., ISS,)
• Update user profiles
• Lock user accounts (e.g., for leaves of absence, etc.)
• Create additional My ARC administrators (e.g., My ARC Administrators, Tool Administrators, etc.)

Additional information concerning My ARC Primary Administrator can be accessed at www.arccorp.com/myarc/

New My ARC Primary Administrator Information

Current My ARC User ID (to be upgraded):

Or if a New My ARC Primary Administrator is requested then provide following information:

Name of the Administrator (First Name, Last Name):  

Email Address (This must be a unique email address only accessible by the designated My ARC Primary Administrator):

Title (If an Owner or officer, please indicate):

Department:

Phone:

Extn:

Fax:

Current My ARC Primary Administrator Information

My ARC User ID:

Downgrade Administrator to:

My ARC Administrator and Tool Administrator
My ARC Administrator
Tool Administrator
User

Or

Delete Administrator

Note: By default, Current My ARC Primary Administrator is downgraded to a 'User' role the when a New My ARC Primary Administrator is re-designated.

Part B2 - Document Retrieval Service (DRS)

New DRS Principal Information

Name of the Principal (First Name, Last Name):  

Email Address:

Title (If an Owner or officer, please indicate):

Phone:

Extn:

Fax:

Identity Verification Question and Answer

Please provide a question and answer, which should be known only to the Principal, for identity verification purposes. The question and answer that you provide below will be used to verify your identity if you contact ARC with questions about changes to the Security Manager, the Service, password resets, User IDs, etc.

Your Question:

Your Answer:

This Identity Verification Question and Answer must be kept confidential by the Agency's Principal and must not be shared with anyone who is not authorized to act on your behalf.

DRS Security Manager will perform the DRS administrative functions for your organization, including, without limitation

• Grant and Revoke user access to DRS
• Create and Perform maintenance of Regular DRS Supervisors and Regular DRS Users,
• Reset passwords
• Delete DRS Users

Additional information can be accessed at www.arccorp.com/solutions/document-retrieval-service-carriers.jsp

New DRS Security Manager Information

Current DRS User ID (to be upgraded):

Or if a New DRS Security Manager is requested then provide following information:

Name of the Security Manager (First Name, Last Name):  

Email Address:

Title (If an Owner or officer, please indicate):

Phone:

Extn:

Fax:

Part C - Certification

By the signature of its authorized Representative (Principal*) below, Carrier hereby certifies that the information provided herein is true and accurate and that the Carrier Representative signing on its behalf is authorized to execute this Re-designation Form on its behalf and to legally bind the Carrier.

AGREED TO BY:

Carrier Legal Name:
Signature:
Print Name:
Title:
Date:

By signing above, I certify that I am authorized to sign this Application on behalf of the Carrier named above.

*Principal means the person who is authorized to designate the Primary Administrator on behalf of the Carrier. For a Carrier that is a U.S. corporation, the signature of a Vice President or above is required. For a Carrier that is not a U.S. corporation, the signature of a Vice President or equivalent is required, or alternatively, the signature of the highest senior level official in the U.S

ARC will endeavor to complete the requested change within 4 business days of receipt of an accurate and complete form. If a re-designation is needed on an expedited basis, please contact ARC's Carrier Help Desk with such request.

Confirmation of the re-designation will be sent to your organization's authorized location. The re-designated Administrator will have the capability to perform all administrative functions relating to your organization's use of the applicable ARC Tools.

Where to send the Completed Form

Please forward the completed and signed original form to:

ARC Attn: ARC's Carrier Help Desk
3000 Wilson Boulevard, Suite 300
Arlington, VA 22201-3862

Or you may fax the completed form to +1 703.341.1227.

Questions or Assistance

If you have any questions about how to complete the Re-designation Form, please contact the ARC Carrier Help Desk at chd@arccorp.com or call +1 703.816.8007.