Create Administrative User Account

	Create Administrative User Account

	Enter Administrative User Information
	An administrative user has the ability to access and perform all functions within the self-service portal. They also have the capability to give other users access to the portal. Please provide the user information below to create an administrative user account.

*Indicates a required field

* Legal Name:
* FEIN, without dash(-):
* Type of Account:
	Employer
		Enter your UC account number, without dash(-):
		I do not have a UC account number. (You will be prompted to create an account after you login.)
	Third Party Administrator
		Enter your TPA account number:
		I do not have a TPA account number. (You will be prompted to create an account after you login.)

Enter Administrative User Information