AFS - Carrier Login Request

Request Carrier User Account
Carrier Name
First Name
Last Name
Phone Number (nnn) nnn-nnnn
E-mail Address
Address (Street, City, State, Zip)

Why do I need to update my old account?
In order to assure uniform security measures across all user accounts, we have added new fields to our user information forms. These new fields are our assurance to you that we are incorporating measures to protect against fraudulent transactions. In updating these forms, we are also ensuring that we are keeping up-to-date with your needs.
What happens next?
Once you have completed the form, a customer service representative will verify your information and send you your login information by e-mail or by telephone. Simply follow the instructions provided by customer service and complete the instructions on the web page.