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Secure Information Exchange Hub (SIEH) Web Service Request
Delivering Technology that Innovates
1 of 2
Complete form, print, route for signatures, scan and email completed and signed form to [email protected].
Producer Type:
E-Mail Address:
DDS or EIN:
Name (Last, First, MI):
Phone Number:
Agency Name:
Signature: Date:
E-Mail Address:
Name (Last, First, MI):
Phone Number:
Signature: Date:
Test Add Modify Service
See Attached
Provider Application IP Address:
Web Service Contact Information - Requester
Web Service Contact Information – Requester’s Information Security Officer
Web Service Provider Information
Description:
Rules to apply:
End Date: Date (Temp):
URL ProvidedSOAP REST WSDL Location:
WSDL or REST URL:
Production
Delete
Is this request for:
Change Type:
Access Limitations:
Service Type:
Modify Consumer IP
Delivering Technology that Innovates
2 of 2
P:\BPM\Service Catalog 2016\Current Docs from SP\Supplemental Documentation\xML Firewalls - Web Services Request\Web Services Request Form 2.3.docx, DTI/AD; DTI/CPC/OCM, dmk/10/9/17
# of Messages:
Schedule Time:
Publicly Available:
Schedule Frequency:
Consumer Application Name:
Max Message Size:
Required Availability:
WSDL WSI Compliant:
Data Classification:
WSDL Document Literal:
Provider SSL: Consumer SSL:
Consumer Type:
E-Mail Address:
DDS or EIN:
Name (Last, First, MI):
Phone Number:
Agency Name:
Signature: Date:
E-Mail Address:
Name (Last, First, MI):
Phone Number:
Signature: Date:
For assistance or questions completing this form contact [email protected].
Web Service Consumer Contact Information
Web Service Consumer Information Security Officer's Contact Information
Secure Information Exchange Hub (SIEH) Web Service Request
Consumer Application IP Address:
So that we may provide you the best service possible, all previous versions of this form are obsolete and will not be accepted.