Access Indiana Client Set-up Request

Access Indiana Client Set-up Request

Agency Name*

First Name*

Last Name*

Email Address*

Phone*

Agency Security Coordinator Name*

Agency Security Coordinator Email Address*

Agency Security Coordinator Phone Number*

Application Name*

This name is visible to the user

Application URL:*

Application outside the State Network?

If your application is outside the State network, you may need to provide additional firewall information

Are Cookies used for Authentication?

If your application does not utilize cookies, you may need to provide additional information

Would you like to set-up a localhost Client ID?

Development URLs

URL for Application DEV Environment

URL for Application QA Environment

URL for Application UAT Environment

URL for Application Integration Environment

URL for Application PROD Environment

Agency Return URL

The URL that Access Indiana will return the user to once authenticated

Agency Initiated Sign-In

Front channel path over which users are directed once authorized from Agency

Agency Initiated Application sign-out Re-direct

Front channel path over which users are directed after sign-out from Agency

Access Indiana Application sign-out Re-direct

Back channel path over which users are directed after sign-out from Access Indiana

Additional URIs: (if applicable)

File Attachments

Drag and drop files here or

Send me a copy of my responses