NENA CID Application Form

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» Please complete and submit the form below to apply for a new Company Identifier.

» Need help? Hover over the underlined text for additional information, or review the instructions found here.

» Search the online database to see if a CID already exists.

Requested Company Identifier (CID) *• Company IDs must be unique. Search the existing list of IDs to ensure the chosen ID does not already exist in the database. • The chosen Company ID can be Alpha and/or Numeric, and should be easily identified as the company’s name. • All IDs in the database must be unique, and comprised of a minimum of three (3) characters and a maximum of five (5).
Number of Access Lines *
CID Admin Name *• Company Identifier Administrator • The CID Admin must verify the Company ID information yearly to ensure all data is accurate.
CID Admin Title *
CID Admin Email *
Company Name *
Company Address *
Company Address Cont.
Company City *		Company State (abbrv.) *
Zip/Postal Code *		CID Admin Phone *
24x7x365 Phone *• This number will be used by Public Safety Answering Points (PSAPs) to request information when there are problems with 9-1-1 calls from your customers. • The preferred method for answering the mandatory 24x7 contact number is by a live person. In cases where a company requesting a NENA ID does not have 24x7 assistance, the daytime number (NOC/Repair) must have a recording indicating how someone from the company can be contacted after hours. • If a company has multiple emergency contact numbers, a unique Company ID must be created for each 24x7 telephone number.
Area Served - One or MoreCheck one or more to indicate your service area.	USA - Nationwide Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming
Type of Local Service *	9-1-1 Admin-CPE ALI (9-1-1 Jurisdiction/PSAP ONLY) Cable Digital CLEC Facility CLEC Reseller CLEC UNE Co-Op/Rural Database Management System Provider ERDB ILEC Internet Protocol Relay Provider PBX/PS911/Shared Tenant Wireless/Cellular/PCS Video Relay Service VoIP Reseller VoIP Provider VDB VPC Other (must identify below)
If Other - Describe
SPID
Billing Contact Name *
Billing Company *Enter SAME if billing info is the same as the company info entered above.
Billing Address
Billing Address 2
Billing City		Billing State
Billing Postal Code		Billing Phone
Billing Email *
Submitted by Name *		Submitted by Title *
Submitted by Phone *		Submitted by Email *
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