CSAT User Registration

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Submitter

The Submitter is certified by the company or corporation to formally submit the regulatory data to DHS.
The Submitter must be an officer of the corporation (or equivalent) or designated by an Officer of the Corporation, and domiciled in th
First Name:

Middle Initial:

Last Name:

Organization:
Mailing Address 1:
Mailing Address 2:
City:
State:
Phone Number:

ZIP Code:
(

)

-

Extension:

E-mail Address:
Is the Submitter a U.S. Citizen?

Yes

No

Is the Submitter an Officer of the Corporation or designated by an Officer of the Corporation?

Yes

No

Is the Submitter domiciled in the U.S.?

Yes

No

Authorizing Person
The Authorizer verifies that the user account request for the Submitter is valid on behalf of the company that owns the facility.
Is the Authorizer the same as the Submitter?

Yes

No

First Name:

Middle Initial:

Last Name:

Organization:
Mailing Address 1:
Mailing Address 2:
City:
State:
Phone Number:

ZIP Code:
(

)

-

Extension:

E-mail Address:
Job Title:
Is the Authorizer a U.S. Citizen?

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Yes

No

2/26/2008

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Is the Authorizer an Officer of the Corporation or designated by an Officer of the Corporation?

Yes

No

Is the Authorizer domiciled in the U.S.?

Yes

No

Continue to Facility Information »

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2/26/2008