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Service Provider Registration
View Registration Instructions


 
Personal & Contact
     
     
  Full Name
(initials not acceptable)
First Name Middle Name Last Name
       Please enter your name exactly as shown on your income tax return form
     
  User Name
  Password  

Password should atleast be of 8 characters with 1 Capital letter,1 lowercase letter,1 special charater and a number
  Confirm Password
  Primary Email:
     
  Interested In: CAT  Daily  Desk 
     
  Date of Birth:
  Address
  Zip:
  State:
  City:
     
  Social Security Number:
  Primary Phone:
  Mobile Phone:   

          By registering you are agreeing to receive texts and emails from Pacesetter Claims Service
 

 

Registration Instructions

1. Once you begin with your registration, you may first fill in personal details such as your Full Name, User Name, Password, Social Security Number, Physical Address and Email Address and then click on the "Save" button.

2. After you 'Save' you will be required to validate your email address. This will enable us to send you notifications as far as deployment or revenue generating opportunities for you. You will receive a Welcome e-mail as soon as your registration form is saved and validated. This welcome email will include your User Name and Password.

3. You may then continue filling other details on the registration form. If you wish you may come back to it later by logging into your account.

4. You need to review and electronically sign documents such as the Agreement/Contract, W9 and Direct Deposit form (optional) from the “Others & Agreement” tab. However you need to save your registration and then login back to e-sign the documents.

 
Profile Progress Information
Including the following information will improve your Profile Completion Progress. To refresh this list click on the "Save" button.
First Name
Last Name
Service Provider Photo
User Name
Password
Email
Street Address
Zip
State
City
SSN
Social Security Card Copy
Drivers License Copy
Drivers License Number
Drivers License State
Date of Birth
Place of Birth
Home Phone
Mobile Phone
Facebook
Twitter
Google+
List of residences for the last ten(10) years
Primary Language
Other Languages
Shirt Size
Professional References
Education
Software Experience
Experience on Claim Types
Capability to Climb
Capability To Climb Steep
Auto Carrier
Auto Limit
Auto Policy Number
Auto Expiry
Professional, occupational and vocational Licenses
List of Professional Designations
Claim Type Preferences
Other Claim Type Preferences
Consider working a desk as an Inside Examiner
Experience working as an Inside Examiner
Experience working as an Inside Examiner Date
Company (Inside Examiner)
Copy of Agreement Document
Copy of W9 Document
Copy of Direct Deposit Form
 
Server: PCS-TEST-APP01
Registration Instructions

Welcome to the Pacesetter Claims service provider registration page.

If you are looking to join our roster of licensed (where required) Independent Insurance Adjusters, please click here

If you are looking to join our approved list of other vendor contractors, please click here