Forgot User ID

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	Forgot User ID * Indicates a required field. Enter the following account information. We will use these values to help identify your account. If we find a match, an email will be sent to your email address on record. User Type User Type is a required field. Trading Partner ID Trading Partner ID is a required field. The text field contains invalid characters. Acceptable characters include [a-z], [A-Z], [0-9], spaces and characters [.?!,()-_+';:"]. Billing Agency Name Billing Agency Name is a required field. The text field contains invalid characters. Acceptable characters include [a-z], [A-Z], [0-9], spaces and characters [.?!,()-_+';:"]. FEIN (Tax ID) FEIN (Tax ID) is a required field.

R4.4.02