Online Employer User ID Registration
*Required Field
Please supply the following Information as reported to the Social Security System
The following characters are not allowed:
# % ( ) \
Employer Information
*
Employer ID:
-
*
Date Coverage:
*
Address Line 1:
(House or Lot or Blk # / Street Name)
Address Line 2:
(Brgy / Subdivision / Municipality)
*
City/Province:
*
Postal Code:
*
Company Email Address:
*
Confirm Company Email Address:
*
Preferred User ID:
Length must be 8-20 characters. First character must be alphabetic. No special characters except underscore. (Ex. LordoftheWebInc_12)
*
Confirm Preferred User ID:
Landline Number:
Mobile Number:
Enter the code as it is shown:
This field helps prevent automated access.