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)
*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.