Claimant Registration Section

Claimant

Select Account Type

First Name

Last Name

Middle Initial

Select Address Type

Street Address

Zip Code

City

Province / State

Street Address

Postal Code

City/Town/Locality

Country

Confirm Email

Phone Check if foreign phone number

Birth Date

Business Name

Select Address Type

Street Address

Zip Code

City

Province / State

Street Address

Postal Code

City/Town/Locality

Country

Confirm Email

Phone Check if foreign phone number

User Name:

Password Passwords must be between 8 and 26 characters and contain at least one special character (e.g. $,\&.#!). Passwords must have at least one digit (‘0’-‘9’) and at least one uppercase (‘A’-Z’)

Confirm password Passwords do not match

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Claimant Registration Section

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