MacysNet - 856 / UCC-128 Test / Audit Request Form

EDI 856 / UCC 128 Test / Audit Request Form

Type of Request

Test Audit

Company Name

Parent Company

Qualifier & ID

Contact Name

E-Mail Address

Phone Number

(xxx)xxx-xxxx Ext:

If using a third party server provider, complete the following:

EDI Service Provider

Contact Name

E-Mail Address

Phone Number

(xxx)xxx-xxxx Ext:

SHIPPING INFORMATION

Division	BOL	PO