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EPA Web Application Access Self Registration

PURPOSE

This form is for outside business partners and affiliates to request access to an authorized EPA Community/Application.


IMPORTANT NOTE:

THIS FORM is ONLY for outside business partners and affiliates that do not have an EPA LAN account.


DO NOT complete if you are an EPA employee or an on-site contractor with an EPA LAN account. If you have an EPA LAN account and are having difficulty logging in, contact the EPA Call Center 1-866-411-4372

ALL FIELDS ARE REQUIRED
 
   e.g. emailId@epa.gov
   e.g. (xxx) xxx-xxxx
Your Information
   e.g. emailId@domainname.com
 


  

Passwords must be at least 8 characters long and contain at least one lower case letter and one number and no spaces



               

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