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Revision 570 - (show annotations) (download)
Mon Jul 20 12:05:04 2009 UTC (12 years, 4 months ago) by wvengen
File MIME type: text/plain
File size: 4835 byte(s)
fix mixup of comma/slash notation for dn
1 <html>
2 <head>
3 <title>Verification form</title>
4 <link rel="stylesheet" type="text/css" href="verification_form.css"/>
5 </head>
6 <body>
7 <div class="form">
8 <h1>DutchGrid Certification Authorities Registration</h1>
9
10 <table class="reserved">
11 <tr>
12 <th class="title nowrap">Reserved for CA operations use</th>
13 <td class="fillin" style="text-align: right">........ - ......</td>
14 </tr>
15 <tr>
16 <td colspan="2" class="fillin-fixed"><span c="${subject.x-dn-slash}">/O=dutchgrid/O=users/O=fooinc/CN=John Doe</span></td>
17 </tr>
18 <tr>
19 <td colspan="2">
20 <span class="check">ID Document valid</span>
21 <span class="check">PoP Challenge verified</span>
22 <span class="check">RA Signature OK</span>
23 </td>
24 </tr>
25 </table>
26
27 <div class="userdata">
28 <table><tr>
29 <td class="userinfo" style="width: 60%" rowspan="2">
30 <table>
31 <tr><td colspan="2">Surname <br/><div class="fillin" c="${surname}">Doe</div></td></tr>
32 <tr><td colspan="2">Given names <br/><div class="fillin" c="${givenname}">John</div></td></tr>
33 <tr>
34 <td>Place of Birth <br/><input type="text" class="fillin" name="birthplace" size="20"/></td>
35 <td style="text-align:right">Date of birth <br/><input type="text" class="fillin" name="birthdate" size="8"/></td>
36 </tr>
37 <tr><td colspan="2">Identity paper type, number, country <br/><input type="text" class="fillin" name="id" size="30"/></td></tr>
38 <tr><td colspan="2">SOFI number <span class="comment">(optional)</span><div class="fillin" c="${sofi}"></div></td></tr>
39 </table>
40 </td>
41 <td class="ra">
42 <div class="nowrap center">send this form by mail or fax to</div>
43 <address class="clear" style="vertical-align: bottom; border: 2px solid black;">DutchGrid MS CA
44 NIKHEF c/o Djuhaeri Harapan
45 P.O. Box 41882
46 NL 1009 DB Amsterdam
47 The Netherlands
48
49 fax: +31 20 592 5155
50 </address>
51 </td>
52 </tr></table>
53
54 <div class="pop">
55 <h2>The first twenty (20) characters of your proof-of-possession challenge:</h2>
56 <div class="fillin" c="${modulus.first20}">0123456789ABCDEF0123</div>
57 </div>
58
59 <div class="contact">
60 <h2>Contact Information</h2>
61 </div>
62
63 <table class="userinfo">
64 <tr>
65 <td>Name <br/><div class="fillin" c="${givenname} ${surname}">John Doe</div></td>
66 <td>Street addres <span class="comment">(physical delivery address)</span> <br/><input type="text" class="fillin" name="street"/></td>
67 </tr>
68 <tr>
69 <td>Organisation <br/><div class="fillin" c="${org.name}">Foo inc.</div></td>
70 <td>ZIP code <br/><input type="text" class="fillin" name="zip"/></td>
71 </tr>
72 <tr>
73 <td>Phone number <br/><input type="text" class="fillin" name="phone"/></td>
74 <td>Place <span class="comment">(and province where applicable)</span> <br/><input type="text" class="fillin" name="place"/></td>
75 </tr>
76 <tr>
77 <td>Email address <br/><input type="text" class="fillin" name="email"/></td>
78 </tr>
79 </table>
80
81 <div class="signature">
82 <h2>Signature</h2>
83
84 I have filled all data truthfully and to the best of my knowledge, and will
85 abide by the <a href="http://ca.dutchgrid.nl/medium/policy/">certificate policy
86 and practice statement</a> of the DutchGrid Certification Authority.
87
88 <table class="signature"><tr>
89 <td class="signature-box" rowspan="2">Signature <div class="fillin"></div></td>
90 <td class="signature-info">Place and date <div class="fillin"></div></td>
91 </tr>
92 <tr><td>
93 Please take this form to <span c="${org.ra.name}"/>
94 <a href="mailto:${org.ra.email}" c="&amp;lt;${org.ra.email}&amp;gt;">**your agent**</a>
95 </td></tr></table>
96 </div>
97
98 </div>
99
100
101 <table class="reserved signature">
102 <tr><th colspan="2" class="title nowrap">Reserved for RA operations use</th></tr>
103
104 <tr><td colspan="2" class="ra">
105 I, <span class="fillin"><sup>RA name</sup></span> have
106 verified the identity of the requester based on the identity piece
107 listed above, and confirm that the information is complete and
108 accurate.
109 I met the applicant in person on
110 <span class="fillin"><sup>date and time of meeting</sup></span> at
111 <span class="fillin"><sup>meeting place</sup></span> and have confirmed
112 his affiliation with <span class="fillin"><sup>organisation name</sup></span>
113 to the extent required in the
114 <a href="http://ca.dutchgrid.nl/medium/policy/">CP/CPS</a>.
115 </td></tr>
116 <tr>
117 <td class="notes-box">Notes</td>
118 <td class="signature-box">Signature of registration authority<br/><br/><br/><br/></td>
119 </tr>
120 </table>
121 </div>
122 </body>
123 </html>

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