Type of Request:
 
Address Change
*Login ID:
*Name:
Title:
Company:
Valid email address format *Email:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX *Phone:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX Fax:
Address:
City:
State:
Zip:

NEW ACCOUNT INFORMATION
Apply to
Name:
Title:
Company:
Valid email address format Email:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX Phone:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX Fax:
Address:
City:
State:
Zip:
AUTHORIZATION INFORMATION
Valid email address format Authorized By (Enter Email):
Valid format is mm/dd/yyyy Date:
Federal Tax ID# (Optional):
Account Information
*Login ID:
*Name:
Title:
Company:
Valid email address format *Email:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX *Phone:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX Fax:
Address:
City:
State:
Zip:

DVD Details
Reason for Request
DVD Requested
Interchange Action Request
Valid format is mm/dd/yyyy Date:
Yard Name:
Contact Name:
Products Used:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX Yard Phone Number:
Valid email address format Email:
Valid email address format Email Confirmation:
ACTION REQUEST INFORMATION INFORMATION
Part Type:
Interchange #:
Manufacturer:
Hollander Interchange Release:
Valid format is yyyy Year:
Model:
VIN# (if applicable):
Description of Request:
Hollander/Audatex offers a service to body shops and insurers using an Audatex estimating system that allows them to insert recycled parts into their estimates. This service is called PXS (Parts Exchange Salvage), and is branded in Audatex Estimating as RSDL (Real Steel Download). The source of the data is your EDEN Inventory.
To OPT OUT from the Real Steel Download, please fill out this form and click "Submit".
If you OPT OUT your EDEN WILL NOT BE LISTED under the Audatex Parts Exchange Salvage (PXS) Service

Parts Exchange Salvage Opt Out
Customer # (See top right of monthly invoice):
Yard Name:
Yard City:
Yard Sate or Province:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX Yard Phone Number:
Your Name:
Valid email address format Email:
Valid email address format Email Confirmation:
Your Reason to "OPT OUT"
Comments:
Sales Support
Sales : +1 800.825.0644 x3237
*Required Field
*First Name:
*Last Name:
*Company:
Valid email address format *Email:
Valid email address format *Confirm Email:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX Telephone:
Address:
City:
State:
Zip:
Country:
Industry:
Solution Interest:
Additional Comments:
Please send me information on future projects services, events and offers. (Audatex does not distribute or sell your information)
How did you hear about us?
Tech Support
Support Phone: 800.825.0092
*Required Field
*Login ID:
*Name:
*Company:
Valid email address format *Email:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX *Phone:
*Product:
How can we assist you?:
Training Support
*Required Field
*Login ID:
*Name:
*Company:
Valid email address format *Email:
Valid format is (XXX)XXX-XXXX or XXX-XXX-XXXX *Phone:
*Product:
How can we assist you?: