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FORM ITEMS DESCRIPTION (FID)
EPA KEY CONTACTS FORM
Version(s): here | |||
|---|---|---|---|
| Version | Name | Status | Actions |
| EPA KEY CONTACTS FORM | Active | ||
Version 2.0 Data Elements: | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Field Number | Field ID | Field Label | Is Required | Min Occurrences | Max Occurrences | Business Rules | List of Values | Min Characters or Value | Max Characters or Value | Help Tip |
| B1-02 | AOR Name Text | Name: | No | 0 | 1 | |||||
| B1-03 | AOR Prefix | Prefix: | No | 0 | 1 | Mr.; Mrs.; Miss; Ms.; Dr.; Rev.; Prof. | 0 | 10 | Please select the Authorized Representative's Prefix from the provided list or enter a new Prefix not provided on the list. | |
| B1-04 | AOR First Name | First Name: | No | 0 | 1 | Conditionally required if any Authorized Representative fields are entered. | 0 | 35 | Please enter the Authorized Representative's First Name. | |
| B1-05 | AOR Middle Name | Middle Name: | No | 0 | 1 | 0 | 25 | Please enter the Authorized Representative's Middle Name. | ||
| B1-06 | AOR Last Name | Last Name: | No | 0 | 1 | Conditionally required if any Authorized Representative fields are entered. | 0 | 60 | Please enter the Authorized Representative's Last Name. | |
| B1-07 | AOR Suffix | Suffix: | No | 0 | 1 | Jr.; Sr.; M.D.; Ph.D | 0 | 10 | Please select the Authorized Representative's Suffix from the provided list or enter a new Suffix not provided on the list. | |
| B1-08 | AOR Title | Title: | No | 0 | 1 | 0 | 45 | Please enter the Authorized Representative's Title. | ||
| B1-09 | AOR Address | Complete Address: | No | 0 | 1 | |||||
| B1-10 | AOR Street 1 | Street1: | No | 0 | 1 | Conditionally required if any Authorized Representative fields are entered. | 0 | 55 | Please enter the first line of the Authorized Representative's Street Address. | |
| B1-11 | AOR Street 2 | Street2: | No | 0 | 1 | 0 | 55 | Please enter the second line of the Authorized Representative's Street Address. | ||
| B1-12 | AOR City | City: | No | 0 | 1 | Conditionally required if any Authorized Representative fields are entered. | 0 | 35 | Please enter the Authorized Representative's City. | |
| B1-13 | AOR State | State: | No | 0 | 1 | Active & not required when form is first opened. After exiting country field, conditionally active and required if Country is US, inactive if Country is not US. | 50 US States, US possessions, territories, military codes | 0 | 55 | Please enter the Authorized Representative's State. Select from the pull down menu. |
| B1-14 | AOR Zip / Postal Code | Zip / Postal Code: | No | 0 | 1 | Conditionally required if Country is US. If Country is not US, then optional. | 0 | 30 | Please enter the Authorized Representative's Zip / Postal Code. | |
| B1-15 | AOR Country | Country: | No | 0 | 1 | Conditionally required if any Authorized Representative fields are entered. | GENC Standard Ed3.0 Update 11 | 0 | 49 | Please enter the Authorized Representative's Country. Select from the pull down menu. |
| B1-16 | AOR Phone Number | Phone Number: | No | 0 | 1 | Conditionally required if any Authorized Representative fields are entered. | 0 | 25 | Please enter the Authorized Representative's Phone Number. | |
| B1-17 | AOR Fax Number | Fax Number: | No | 0 | 1 | 0 | 25 | Please enter the Authorized Representative's Fax Number. | ||
| B1-18 | AOR E-mail Address | E-mail Address: | No | 0 | 1 | E-mail validation | 0 | 60 | Please enter the Authorized Representative's E-mail Address. | |
| B2-02 | Payee Name | Name: | No | 0 | 1 | |||||
| B2-03 | Payee Prefix | Prefix: | No | 0 | 1 | Mr.; Mrs.; Miss; Ms.; Dr.; Rev.; Prof. | 0 | 10 | Please select the Payee's Prefix from the provided list or enter a new Prefix not provided on the list. | |
| B2-04 | Payee First Name | First Name: | No | 0 | 1 | Conditionally required if any Payee fields are entered. | 0 | 35 | Please enter the Payee's First Name. | |
| B2-05 | Payee Middle Name | Middle Name: | No | 0 | 1 | 0 | 25 | Please enter the Payee's Middle Name. | ||
| B2-06 | Payee Last Name | Last Name: | No | 0 | 1 | Conditionally required if any Payee fields are entered. | 0 | 60 | Please enter the Payee's Last Name. | |
| B2-07 | Payee Suffix | Suffix: | No | 0 | 1 | Jr.; Sr.; M.D.; Ph.D | 0 | 10 | Please select the Payee's Suffix from the provided list or enter a new Suffix not provided on the list. | |
| B2-08 | Payee Title | Title: | No | 0 | 1 | 0 | 45 | Please enter the Payee's Title. | ||
| B2-09 | Payee Address | Complete Address: | No | 0 | 1 | |||||
| B2-10 | Payee Street 1 | Street1: | No | 0 | 1 | Conditionally required if any Payee fields are entered. | 0 | 55 | Please enter the first line of the Payee's Street Address. | |
| B2-11 | Payee Street 2 | Street2: | No | 0 | 1 | 0 | 55 | Please enter the second line of the Payee's Street Address. | ||
| B2-12 | Payee City | City: | No | 0 | 1 | Conditionally required if any Payee fields are entered. | 0 | 35 | Please enter the Payee's City. | |
| B2-13 | Payee State | State: | No | 0 | 1 | Active & not required when form is first opened. After exiting country field, conditionally active and required if Country is US, inactive if Country is not US. | 50 US States, US possessions, territories, military codes | 0 | 55 | Please enter the Payee's State. Select from the pull down menu. |
| B2-14 | Payee Zip / Postal Code | Zip / Postal Code: | No | 0 | 1 | Conditionally required if Country is US. If Country is not US, then optional. | 0 | 30 | Please enter the Payee's Zip / Postal Code. | |
| B2-15 | Payee Country | Country: | No | 0 | 1 | Conditionally required if any Payee fields are entered. | GENC Standard Ed3.0 Update 11 | 0 | 49 | Please enter the Payee's Country. Select from the pull down menu. |
| B2-16 | Payee Phone Number | Phone Number: | No | 0 | 1 | Conditionally required if any Payee fields are entered. | 0 | 25 | Please enter the Payee's Phone Number. | |
| B2-17 | Payee Fax Number | Fax Number: | No | 0 | 1 | 0 | 25 | Please enter the Payee's Fax Number. | ||
| B2-18 | Payee E-mail Address | E-mail Address: | No | 0 | 1 | E-mail validation | 0 | 60 | Please enter the Payee's E-mail Address. | |
| B3-02 | Administrative Contact Name | Name: | No | 0 | 1 | |||||
| B3-03 | Administrative Contact Prefix | Prefix: | No | 0 | 1 | Mr.; Mrs.; Miss; Ms.; Dr.; Rev.; Prof. | 0 | 10 | Please select the Administrative Contact's Prefix from the provided list or enter a new Prefix not provided on the list. | |
| B3-04 | Administrative Contact First Name | First Name: | No | 0 | 1 | Conditionally required if any Administrative Contact fields are entered. | 0 | 35 | Please enter the Administrative Contact's First Name. | |
| B3-05 | Administrative Contact Middle Name | Middle Name: | No | 0 | 1 | 0 | 25 | Please enter the Administrative Contact's Middle Name. | ||
| B3-06 | Administrative Contact Last Name | Last Name: | No | 0 | 1 | Conditionally required if any Administrative Contact fields are entered. | 0 | 60 | Please enter the Administrative Contact's Last Name. | |
| B3-07 | Administrative Contact Suffix | Suffix: | No | 0 | 1 | Jr.; Sr.; M.D.; Ph.D | 0 | 10 | Please select the Administrative Contact's Suffix from the provided list or enter a new Suffix not provided on the list. | |
| B3-08 | Administrative Contact Title | Title: | No | 0 | 1 | 0 | 45 | Please enter the Administrative Contact's Title. | ||
| B3-09 | Administrative Contact Address | Complete Address: | No | 0 | 1 | |||||
| B3-10 | Administrative Contact Street 1 | Street1: | No | 0 | 1 | Conditionally required if any Administrative Contact fields are entered. | 0 | 55 | Please enter the first line of the Administrative Contact's Street Address. | |
| B3-11 | Administrative Contact Street 2 | Street2: | No | 0 | 1 | 0 | 55 | Please enter the second line of the Administrative Contact's Street Address. | ||
| B3-12 | Administrative Contact City | City: | No | 0 | 1 | Conditionally required if any Administrative Contact fields are entered. | 0 | 35 | Please enter the Administrative Contact's City. | |
| B3-13 | Administrative Contact State | State: | No | 0 | 1 | Active & not required when form is first opened. After exiting country field, conditionally active and required if Country is US, inactive if Country is not US. | 50 US States, US possessions, territories, military codes | 0 | 55 | Please enter the Administrative Contact's State. Select from the pull down menu. |
| B3-14 | Administrative Contact Zip / Postal Code | Zip / Postal Code: | No | 0 | 1 | Conditionally required if Country is US. If Country is not US, then optional. | 0 | 30 | Please enter the Administrative Contact's Zip / Postal Code. | |
| B3-15 | Administrative Contact Country | Country: | No | 0 | 1 | Conditionally required if any Administrative Contact fields are entered. | GENC Standard Ed3.0 Update 11 | 0 | 49 | Please enter the Administrative Contact's Country. Select from the pull down menu. |
| B3-16 | Administrative Contact Phone Number | Phone Number: | No | 0 | 1 | Conditionally required if any Administrative Contact fields are entered. | 0 | 25 | Please enter the Administrative Contact's Phone Number. | |
| B3-17 | Administrative Contact Fax Number | Fax Number: | No | 0 | 1 | 0 | 25 | Please enter the Administrative Contact's Fax Number. | ||
| B3-18 | Administrative Contact E-mail Address | E-mail Address: | No | 0 | 1 | E-mail validation | 0 | 60 | Please enter the Administrative Contact's E-mail Address. | |
| B4-02 | Project Manager Name | Name: | No | 0 | 1 | |||||
| B4-03 | Project Manager Prefix | Prefix: | No | 0 | 1 | Mr.; Mrs.; Miss; Ms.; Dr.; Rev.; Prof. | 0 | 10 | Please select the Project Manager's Prefix from the provided list or enter a new Prefix not provided on the list. | |
| B4-04 | Project Manager First Name | First Name: | No | 0 | 1 | Conditionally required if any Project Manager fields are entered. | 0 | 35 | Please enter the Project Manager's First Name. | |
| B4-05 | Project Manager Middle Name | Middle Name: | No | 0 | 1 | 0 | 25 | Please enter the Project Manager's Middle Name. | ||
| B4-06 | Project Manager Last Name | Last Name: | No | 0 | 1 | Conditionally required if any Project Manager fields are entered. | 0 | 60 | Please enter the Project Manager's Last Name. | |
| B4-07 | Project Manager Suffix | Suffix: | No | 0 | 1 | Jr.; Sr.; M.D.; Ph.D | 0 | 10 | Please select the Project Manager's Suffix from the provided list or enter a new Suffix not provided on the list. | |
| B4-08 | Project Manager Title | Title: | No | 0 | 1 | 0 | 45 | Please enter the Project Manager's Title. | ||
| B4-09 | Project Manager Address | Complete Address: | No | 0 | 1 | |||||
| B4-10 | Project Manager Street 1 | Street1: | No | 0 | 1 | Conditionally required if any Project Manager fields are entered. | 0 | 55 | Please enter the first line of the Project Manager's Street Address. | |
| B4-11 | Project Manager Street 2 | Street2: | No | 0 | 1 | 0 | 55 | Please enter the second line of the Project Manager's Street Address. | ||
| B4-12 | Project Manager City | City: | No | 0 | 1 | Conditionally required if any Project Manager fields are entered. | 0 | 35 | Please enter the Project Manager's City. | |
| B4-13 | Project Manager State | State: | No | 0 | 1 | Active & not required when form is first opened. After exiting country field, conditionally active and required if Country is US, inactive if Country is not US. | 50 US States, US possessions, territories, military codes | 0 | 55 | Please enter the Project Manager's State. Select from the pull down menu. |
| B4-14 | Project Manager Zip / Postal Code | Zip / Postal Code: | No | 0 | 1 | Conditionally required if Country is US. If Country is not US, then optional. | 0 | 30 | Please enter the Project Manager's Zip / Postal Code. | |
| B4-15 | Project Manager Country | Country: | No | 0 | 1 | Conditionally required if any Project Manager fields are entered. | GENC Standard Ed3.0 Update 11 | 0 | 49 | Please enter the Project Manager's Country. Select from the pull down menu. |
| B4-16 | Project Manager Phone Number | Phone Number: | No | 0 | 1 | Conditionally required if any Project Manager fields are entered. | 0 | 25 | Please enter the Project Manager's Phone Number. | |
| B4-17 | Project Manager Fax Number | Fax Number: | No | 0 | 1 | 0 | 25 | Please enter the Project Manager's Fax Number. | ||
| B4-18 | Project Manager E-mail Address | E-mail Address: | No | 0 | 1 | E-mail validation | 0 | 60 | Please enter the Project Manager's E-mail Address. | |