BADGE/CARD TEST REQUEST FORM

A sample of badge/card must be included with this form. Please ensure the badge/card provided is pro- grammed specifically for your location.

Contact Info – Who is responsible for maintaining badge/card records?

Name: Title:
Email: Phone:
Address: City:
State: Zip:

Badge/Card Technology – What type of technology is used in this facility?

Does the facility use more than one technology?
If Yes, how many different technologies are used?

Circle all that apply

HID HID iClass MiFare DESFire Other:

Programmed Format – How are the badges/cards in your facility programmed?

On the badge/card provided, what number do we need to read:

Total Bits:

First Parity Check (p)
Second Parity Check (p)
Even Parity Check (e) Start Bit
Length
Odd Parity Check (o) Start Bit
Length
CID(c) Start Bit
Length
Facility Code (f) Start Bit
Length
Site codes (s) Start Bit
Length
Manufacturer Code (m) Start Bit
Length
Card Check Format
Parity Check Format
Assigned Facility Code (if applicable)

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