New Company Contact

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Company Name

Person Making Request *

Contact Type *

Add a New Contact
Update Existing Contact
Remove Existing Contact

Contact Name *

First

Last

Job Title

Contact Email *

**Contact login information will be sent here.

Start Date *

Effective Date *

Last Date of Employment *

**The contact’s credentials will be removed or suspended on this date.

Main Phone

Mobile Phone

**If completed, contact MFA will be sent here.

Required Services *

Bitwarden – Password Manager
Google Workspace Account – Email
JustEmail – Email
Microsoft 365 Apps for Business – Productivity
Microsoft 365 Business Basic – Email
Microsoft 365 Business Standard – Email + Productivity
Microsoft 365 Business Premium – Email + Productivity
QBO Payroll – Employee
QBO User – Accounting

**Check all that apply.

Communications

Receive Marketing Emails
Receive Billing Emails
Receive Report Emails

Enable Remote Access *

Remote Access Device(s) *

Contact’s Assigned Device
All Organization Devices

Direct Report *

**A Direct Report’s email will be CC’d on all ticket communications.

Direct Report Name *

Direct Report Email *

Enable Portal User *

Portal Group

Portal User Permission Groups

Existing Email Account *

Do Nothing
Suspend Account – You will still be charged.
Remove the Account – Your next billing will reflect this change.

If the contact has an existing email account, choose what action to take on that account.

Account Removal *

Transfer Files
Delete Account

Please choose an option to transfer the account or delete the account.

Account Delete Disclaimer *

I agree to permanently delete the account. *

By clicking the ‘I agree’ statement above, you agree and understand that the account that you are requesting to be removed will be permanently deleted and irrecoverable by United PC, and that neither United PC or its affiliates will be liable for any data or content contained within, or linked to this account.

Transfer Recipient Name *

Transfer Recipient Email *

Transfer Disclaimer *

I agree to transfer the account contents. *

By clicking the ‘I agree’ statement above, you agree and understand that the account that you are requesting, including its contents, ownership, and, if existing, files and documents associated therein, will be transferred to the account information provided on this form. United PC agrees to provide its best efforts to transfer any and all content related to the existing account to the account provided.

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Disclaimer *

I Agree

By clicking I Agree and submitting this form, you agree to allow United PC to alter your organization contact list with the information shown above. I also agree that I have checked this information for accuracy and find it to be correct, to the best of my knowledge.