Verify your information
Your name as it will appear on your certificate
John Middle Doe, Jr.
Email
email@example.com
Phone Number
(555) 555-5555
City, State, and Zip Code
Anywhere, XX 50505
Birth Year
1901
Last four digits of your Social Security number
1234
You will need this moving forward
Your username is XXX123
Your password is XXX123
