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Relay Request Form

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Division of Information Technology The completed form should be emailed by unit head to [email protected]. 1. Department manager (Name, e-mail, phone): 2. Technical contact (Name, e-mail, phone): 3. Department: 4. Identify the type of relay needed: a. device (printer/scanner/MFC/etc): Ricoh MFC 5. IP address, DNS Name, and Ethernet Jack Number of device to send e-mail: See page 2. 6. Business reason for non-authenticated relaying: Copiers do not support encrypted authentication in Exchange mail system. 7. Certify that: a. system is not an open relay. Y/N: Y b. if applicable, system/application has a virus scanner installed and it downloads signatures every day. Y/N/NA: NA c. system/device is secured according to policies prevent unauthorized use. Y/N: Y 8. Is TLS a supported option for the relay connection? Y/N: N 9. E-mail address(es) of sending application (only @sfsu.edu will be allowed to relay): format: Ricoh*Model*ROOM#@sfsu.edu e.g.: Ricoh*MP2000*[email protected] 10. Certification: I certify that this relay request is for conducting official university business. YES.    You will be contacted within 3 business days regarding your request. The designated SMTP relay server is relay.sfsu.edu. Please make sure to use only the DNS name and not the IP address for relay.sfsu.edu. You will be contacted once a year to verify this relay exception is still required. Return completed form to: xxxxxxx 10/1/2010 Division of Information Technology Building and Room# Serial Number Return completed form to: xxxxxxx Static IP Address DNS Name Ethernet Jack # 10/1/2010