Software developers must provide the information requested below before 2D test will be accepted for testing.
Receipt and acceptance of the required documentation identifies the developer as interested in participating in the 2D
barcode program for Arizona.
It does not represent acceptance of any software nor does it confirm the accuracy of any software developed.
1. Company Name:
2. Product Names:
3. NACTP Code:
4. Primary Contact Name:
5. Contact's Daytime Phone:
6. Contact's E-mail Address:
7. Forms Supported:
140 301
140 Sch A 309
140A 310
140NR 321
Sch A(NR) 322
140PY 323
Sch A(PY) 340
Sch A(PYN) 348
140PTC 352
8. Additional email addresses for contacts and notification:
Submit your completed form to AZBarCode@azdor.gov
Arizona 2D Barcode
Application to Participate
2019
Submit by Email