NENA Company ID Form Posted bynena-9-1-1 February 8, 2024February 8, 2024 Posted: May 19 – 08:02 am Please submit requests for new IDs or to edit existing company ID records. Return to NENA Company ID Page Type Application: * – Select –NEW CIDUpdate Existing CID Company Identifier Code: * Limited to 3-5 characters Company Name: * Company Address Line 1: * Company Address Line 2: Company City: * Company State: * – Select –AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Company Zip: * Billing Company: * Enter SAME if billing info is the same as the company info entered above and skip to Billing Contact. Billing Address Line 1: Billing Address Line 2: Billing City: Billing State: – None –AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Billing Zip: Billing Contact Name: * Billing Contact Phone: * Billing Contact Email: * 24x7x365 Phone: * This number will be used by PSAPs to request information when there are problems with 9-1-1 calls from your customers. Area Served – Select One or More: * USA – Nation-Wide 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 – Select One or More: * 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) Other Local Service (if checked above): SPID: Service Provider ID – Wireline providers Admin Name: * Admin Title: * Admin Phone: * Admin Fax: * Admin Email: * Submitted By Name: * Submitted By Title: * Submitted by Phone: * Submitted by Email: * Number of Access Lines: * – Select –1 – 24,99925,000 – 99,999100,000 – 499,999500,000+ Comments: