Hasler® - Dealer Extranet Account Setup Form

Dealer Principals: Use this form to setup a Hasler Dealer Extranet account for someone at your dealership.   -OR-   Click here to modify an existing user

Print this page and fax it to: (203) 301-3912 ATTN: Dealer & Direct Support Care

Please fill-out the user's information, check-off the desired access-levels for that user, and provide authorization information and signature below, before faxing.

User's Full Name:________________________________________________________________

Dealer Number:____________________________________________________________

Dealer Name:______________________________________________________________

Zip Code:_________________________________________________________________

Telephone:________________________________________________________________

User's Email Address:_______________________________________________________

For security, please enter user's birth date:_______________________________

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I the Dealership/Owner verify that the above information is correct and
authorize Neopost USA Inc. to grant access to the user listed above for
the following areas of the Hasler Dealer Extranet:

(Check all that apply)

__ Technical Support (All-access except for pricing, promos, and admin)

__ Sales (All access except for admin)
 
__ Admin (Access to DealerNet online order management system)


I understand that this user will remain active until I notify Neopost USA Inc.


____________________________________ Owner Signature

____________________________________ Print Name

____________________________________ Date

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(FOR HASLER USE ONLY)

Verified by _____________________

       on   ______/______/_______