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First Name:

Last Name:

Company:

Title:

Address:

Address (cont'd):

City:

State/Province:

Headquarters^*:

^*What state/province is your company’s headquarters located in?

Country:

Zip/Postal Code:

Phone Number:

E-mail:

1. What does your company use as its primary ERP/host accounting system?

JD Edwards EnterpriseOne

JD Edwards World

Lawson

Microsoft Dynamics

Oracle

PeopleSoft

SAP

Home Grown

Other (please specify):

2. What payment/disbursement types are you processing today? (Please select all that apply.)

Checks

ACH

Financial EDI

BASCTEL-IP

SWIFT

Refunds/rebates

Claims

None at the time

Other (please specify):

3. How would you describe the complexity of your payment processing today?

Fairly Simple (i.e., one ERP or legacy system; one bank; 1 or 2 core payment types; domestic payments only)

Somewhat Complex (i.e., more than one ERP or legacy system; more than one bank; several payment types and formats; some international payments)

Very Complex (i.e., multiple ERP and legacy systems; multiple bank relationships; multiple payment types and formats; need to issue payments globally)

4. What is the estimated number of payments that your organization issues/processes in a given month?

Less than 1000

1,000 to 5,000

5,000 to 10,000

10,000 to 25,000

25,000 to 50,000

Greater than 50,000

5. Do you have any security concerns or requirements relative to payment/check issuance? (i.e., need for audit logs, multiple levels of approval, etc.)?

Yes

6. What is your project timeline with regard to payment lifecycle management capabilities?

We are actively looking for a solution provider and plan to purchase in the next 6-12 months.

We have a budget and plan to issue an RFP/RFI soon.

We have secured a budget, but do not yet have a timeframe for purchase.

We do not have a project scheduled at this time.

7. Comments: