ASK Change of Information form

1-800-472-6481

Use this form to:

  • Update Trading Partner information (ie: company organization name, address, phone/fax #'s or email address)
  • Add additional company contacts
  • Change in software vendor

*=required
** = fax number or email address is required

Step 1: Trading Partner Information 
Trading Partner Number : *
Trading Partner/Organization (Legal) Name: *
Trading Partner Mailing Address: *
Trading Partner City: *
Trading Partner State: *
Trading Partner ZIP Code: *
Trading Partner Contact Name(s): *
Trading Partner Phone #:( ) *
Trading Partner Fax #:( ) **
Trading Partner Email Address: **
Comments:



Step 2 : Identify Changes 
What do you need changed?
 
Kansas law applies to this business relationship.