Jefferson County : Data Request Management System

 

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Create a New User Account

Creating a New Account
  • You may start creating a new account by entering the required information below. Please respond to each field as accurately as possible.
  • There are two phases of information collection, after these have been completed, continue on to create an account with a password. Your account will be enabled once your background information has been processed and reviewed.
  • Your email address will be your login.

Personal and Organization Information

First Name:  
Last Name:  
Organizations Name:
Department Position:
Street Address:
City Address:
State:
Zip Code:
Organization's Phone:
Organizations Fax:
Login Information :
   
 
 
 
 
Complete
Your account has been successfully logged. An administrator will be reviewing and contacting you about your account.