Existing Shipper User Request Form

Legal Company Name:*

Access Type:*

Add
Modify
Deactivate

Check Applicable Assets*

AGS
BRD
BSP
SGG
TIO
W10
Blue Union
LEAP

Name:*

Prefix First Middle Last

Office Phone:*

Cell Phone:*

Title:*

Email:*

Department Email:

IM:

Name:*

First Last

User ID:*

Email*

What would you like to modify?*

Name of Person to Remove:*

First Last

Requestor:*

Phone:*

Email:*

Describe Your Role/Access Level

Please select all that apply.

Scheduler

Scheduler

Accounting

Accounting

Measurement

Measurement

Operator

Operator

Marketing

Marketing

Contract Administrator

Contract Administrator

Notifications Requested

Please select all that apply.

Invoice Ready

Contract Reminder

Nomination

Operator Confirmation

System Wide Notices

Capacity Release (BRD Only)

OFO Notifications (BRD Only)

Imbalance Trading (BRD Only)

Name

This field is for validation purposes and should be left unchanged.

Shipper Access Request Form

Describe Your Role/Access Level

Notifications Requested