quickconfirm-west.pwc.com
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https://quickconfirm-west.pwc.com/confirmer/request-reassignment/legalentity?confirmerEmailAddress=ROSS.HUDSON%40CVSHealth.com&con...
Submission: On March 31 via manual from US — Scanned from US
Submission: On March 31 via manual from US — Scanned from US
Form analysis 1 forms found in the DOM
<form novalidate="" class="ng-untouched ng-pristine ng-invalid">
<label>Do you know who is the correct person to respond to PwC's confirmation request?</label>
<br>
<div class="form-check form-check-inline">
<input type="radio" value="true" name="agree" formcontrolname="agree" id="reassign-know-who-is-yes" checked="" class="k-radio ng-untouched ng-pristine ng-valid">
<label for="reassign-know-who-is-yes" class="k-radio-label">Yes</label>
</div>
<div class="form-check form-check-inline">
<input type="radio" value="false" name="agree" formcontrolname="agree" id="reassign-know-who-is-no" class="k-radio ng-untouched ng-pristine ng-valid">
<label for="reassign-know-who-is-no" class="k-radio-label">No</label>
</div>
<div class="row">
<div class="col-sm-12 col-md-8 col-lg-6">
<div formgroupname="knowWhoIsYes" class="card ng-untouched ng-pristine ng-invalid">
<div class="card-body">
<div class="form-group">
<div class="k-checkbox-wrapper">
<input type="checkbox" formcontrolname="isHighRisk" id="reassign-is-group-email" aria-describedby="requestReassignmentGroupEmailHelpText" class="k-checkbox ng-untouched ng-pristine ng-valid">
<label for="reassign-is-group-email" class="k-checkbox-label">Group Email Inbox</label>
</div>
<small id="requestReassignmentGroupEmailHelpText" class="form-text text-muted">This is an email address that can be accessed by multiple individuals (Note: If you are not sure, leave this unchecked)</small>
</div>
<div class="row">
<div class="col-sm-12 col-md-6">
<div class="form-group">
<label for="reassign-confirmer-firstname">Confirmer First Name</label>
<input type="text" formcontrolname="firstName" id="reassign-confirmer-firstname" class="form-control ng-untouched ng-pristine ng-invalid">
<app-show-errors>
<div role="alert" class="input-error" hidden="">
<ul class="unstyled-list">
<!---->
</ul>
</div>
</app-show-errors>
</div>
</div>
<div class="col-sm-12 col-md-6">
<div class="form-group">
<label for="reassign-confirmer-lastname">Confirmer Last Name</label>
<input type="text" formcontrolname="lastName" id="reassign-confirmer-lastname" class="form-control ng-untouched ng-pristine ng-invalid">
<app-show-errors>
<div role="alert" class="input-error" hidden="">
<ul class="unstyled-list">
<!---->
</ul>
</div>
</app-show-errors>
</div>
</div>
<div class="col-sm-12 col-md-6">
<div class="form-group">
<label for="reassign-confirmer-email">Email Address</label>
<input type="text" formcontrolname="emailAddress" id="reassign-confirmer-email" aria-describedby="reassignmentRequestEmailHelpText" class="form-control ng-untouched ng-pristine ng-invalid">
<app-show-errors>
<div role="alert" class="input-error" hidden="">
<ul class="unstyled-list">
<!---->
</ul>
</div>
</app-show-errors>
<small id="reassignmentRequestEmailHelpText" class="form-text text-muted">This is the person/email address that we will resend the request to, instead of you</small>
</div>
</div>
<div class="col-sm-12 col-md-6">
<div class="form-group">
<label for="reassign-confirmer-phonenumber">Telephone Number</label>
<input type="text" formcontrolname="phoneNumber" id="reassign-confirmer-phonenumber" class="form-control ng-untouched ng-pristine ng-invalid">
<app-show-errors>
<div role="alert" class="input-error" hidden="">
<ul class="unstyled-list">
<!---->
</ul>
</div>
</app-show-errors>
</div>
</div>
<div class="col-sm-12 col-md-6">
<div class="form-group">
<label for="reassign-confirmer-country">Country</label>
<kendo-dropdownlist formcontrolname="country" textfield="description" valuefield="id" class="dropdown k-widget k-dropdown k-header ng-untouched ng-pristine ng-valid" dir="ltr"><!----><span unselectable="on" role="listbox"
aria-haspopup="listbox" id="k-84f05697-76c3-429d-942a-77524bb8cbde" dir="ltr" readonly="false" tabindex="0" aria-disabled="false" aria-readonly="false" aria-expanded="false" aria-describedby="866dc79b-11d4-4dbb-b0f1-f7dcf8b7619e"
class="k-dropdown-wrap k-state-default" aria-activedescendant="b9d982c6-6acc-4418-a397-9f0fd366ae80-1"><span unselectable="on" class="k-input" id="866dc79b-11d4-4dbb-b0f1-f7dcf8b7619e"><!---->United States<!----></span><span
unselectable="on" class="k-select"><span class="k-icon k-i-arrow-s"></span></span><!----></span><!----><!----></kendo-dropdownlist>
<app-show-errors>
<div role="alert" class="input-error" hidden="">
<ul class="unstyled-list">
<!---->
</ul>
</div>
</app-show-errors>
</div>
</div>
<div class="col-sm-12">
<div class="form-group">
<label for="reassign-confirmer-yes-reason">Why are you requesting reassignment?</label>
<textarea formcontrolname="reason" id="reassign-confirmer-yes-reason" class="form-control ng-untouched ng-pristine ng-invalid"></textarea>
<app-show-errors>
<div role="alert" class="input-error" hidden="">
<ul class="unstyled-list">
<!---->
</ul>
</div>
</app-show-errors>
</div>
</div>
</div>
</div>
</div>
<div formgroupname="knowWhoIsNo" class="card ng-untouched ng-pristine ng-invalid" hidden="">
<div class="card-body">
<div class="form-group">
<label for="reassign-confirmer-no-reason">Why are you requesting reassignment?</label>
<textarea formcontrolname="reason" id="reassign-confirmer-no-reason" class="form-control ng-untouched ng-pristine ng-invalid"></textarea>
<app-show-errors>
<div role="alert" class="input-error" hidden="">
<ul class="unstyled-list">
<!---->
</ul>
</div>
</app-show-errors>
</div>
</div>
</div>
</div>
</div>
</form>Text Content
* * Quick Confirm * Confirmer Quick Reference Guide * Sign Out Request Reassignment for Shutterfly, LLC Confirmations Use this form to inform the PwC Team that you are not the correct individual to confirm the request that was sent to you. Do you know who is the correct person to respond to PwC's confirmation request? Yes No Group Email Inbox This is an email address that can be accessed by multiple individuals (Note: If you are not sure, leave this unchecked) Confirmer First Name Confirmer Last Name Email Address This is the person/email address that we will resend the request to, instead of you Telephone Number Country United States Why are you requesting reassignment? Why are you requesting reassignment? Go To Log In Page Submit Request © 2010-2022 PwC. All rights reserved. PwC refers to the PwC network and/or one or more of its member firms, each of which is a separate legal entity. Please see www.pwc.com/structure for further details. * Terms of Use * Privacy Policy * Cookie Info