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DMS Polling Data 
Collection Form 
Dealership Information 
Name: __________________________________________________________________________________ 
Address: _________________________________________________________________________________ 
City: ______________________________________ State: ________________ Zip: ___________________ 
Phone: __________________________________________________________________________________ 
Dealer Contact 
First Name: __________________________ Last Name: ___________________________________________ 
Phone: _________________________________ Email: ___________________________________________ 
Technical Contact 
First Name: __________________________ Last Name: ___________________________________________ 
Phone: _________________________________ Email: ___________________________________________ 
VPN Information 
DMS IP Address (if available): _________________________________________________________________ 
Data Source Information: 
DMS System 
 ADP:  -FI  -SL 
Access to ENG (RPG optional but helpful) 
Username: _______________________________ Password: _______________________________________ 
 Reynolds & Reynolds: 
 F&I 
Access to 6910 (optional functions: 4770)
Username: _______________________________ Password: _______________________________________ 
 Other DMS Type: ________________________________________________________________________ 
Please provide the Dealer’s Technical Contact information in the top portion of this form. Authenticom will contact the deale r to 
acquire the proper technical specifications for this DMS Type. 
Other Instructions:

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Lm dms polling data collection form

  • 1. DMS Polling Data Collection Form Dealership Information Name: __________________________________________________________________________________ Address: _________________________________________________________________________________ City: ______________________________________ State: ________________ Zip: ___________________ Phone: __________________________________________________________________________________ Dealer Contact First Name: __________________________ Last Name: ___________________________________________ Phone: _________________________________ Email: ___________________________________________ Technical Contact First Name: __________________________ Last Name: ___________________________________________ Phone: _________________________________ Email: ___________________________________________ VPN Information DMS IP Address (if available): _________________________________________________________________ Data Source Information: DMS System  ADP:  -FI  -SL Access to ENG (RPG optional but helpful) Username: _______________________________ Password: _______________________________________  Reynolds & Reynolds:  F&I Access to 6910 (optional functions: 4770)
  • 2. Username: _______________________________ Password: _______________________________________  Other DMS Type: ________________________________________________________________________ Please provide the Dealer’s Technical Contact information in the top portion of this form. Authenticom will contact the deale r to acquire the proper technical specifications for this DMS Type. Other Instructions: