Here is the link to the form.
Software Vendor Name name - Barnestorm, Inc.
Submitter ID - login ID (you can find this in Barnestorm by going to Codes > Program Related Codes > Payer Codes, click the Electronic Claims Setup tab, and find the SenderID item. This is the mailbox # to fill in on the form.)
EDI Contact Name & Phone - this is your name and business phone number
Don't check anything under Parallel Testing, only under the Production categories that apply to you, and your appropriate jurisdiction. If you don't know these, call Palmetto and ask (Barnestorm does not have the answer).