investor.pccpllc.com
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https://investor.pccpllc.com/join?code=NDk4YjEyZDIyMzY5NzI5ZjRjZTYzODA5NDY4Y2M0MGNkZTQ1NjUxOGdBV1ZOZ0FBQUFBQUFBQktGSFVNQUl3SV...
Submission: On December 20 via manual from SG — Scanned from DE
Submission: On December 20 via manual from SG — Scanned from DE
Form analysis
1 forms found in the DOMPOST /join?code=NDk4YjEyZDIyMzY5NzI5ZjRjZTYzODA5NDY4Y2M0MGNkZTQ1NjUxOGdBV1ZOZ0FBQUFBQUFBQktGSFVNQUl3SVpHRjBaWFJwYldXVWpBaGtZWFJsZEdsdFpaU1RsRU1LQitZTEdRNDVEQWx2QXBTRmxGS1VTZzVjNFFDSGxDND0=
<form role="form" method="POST" action="/join?code=NDk4YjEyZDIyMzY5NzI5ZjRjZTYzODA5NDY4Y2M0MGNkZTQ1NjUxOGdBV1ZOZ0FBQUFBQUFBQktGSFVNQUl3SVpHRjBaWFJwYldXVWpBaGtZWFJsZEdsdFpaU1RsRU1LQitZTEdRNDVEQWx2QXBTRmxGS1VTZzVjNFFDSGxDND0=" class="form-horizontal">
<input type="hidden" name="token" value="NDk4YjEyZDIyMzY5NzI5ZjRjZTYzODA5NDY4Y2M0MGNkZTQ1NjUxOGdBV1ZOZ0FBQUFBQUFBQktGSFVNQUl3SVpHRjBaWFJwYldXVWpBaGtZWFJsZEdsdFpaU1RsRU1LQitZTEdRNDVEQWx2QXBTRmxGS1VTZzVjNFFDSGxDND0=">
<div class="form-group">
<label class="control-label col-sm-3" for="email-address-input"> Email address </label>
<div class="col-sm-6">
<div class="control-text" data-cy="emailValue"> ahenry4@brighthousefinancial.com <div>
<small>
<a href="#" data-cy="altEmailHinkLink" class="reveal-hidden" data-reveal-target="#alternate-email-address">
Not your email address?
</a>
</small>
</div>
<div id="alternate-email-address" class="hidden">
<br> If you are an associate of Ann Scarlett and would like a PCCP, LLC portal account, please contact us at <a href="mailto:Inquiry@pccpllc.com">Inquiry@pccpllc.com</a> or 1 (866) PCCP-LLC.
</div>
</div>
</div>
</div>
<div class="form-group">
<label class="control-label col-sm-3" for="password-input"> Choose a password </label>
<div class="col-sm-6">
<input name="password" id="password-input" type="password" class="form-control" autocomplete="off" value="">
<input type="hidden" name="password_strength" id="password-strength" value="">
<div class="progress password-meter">
<div class="progress-bar progress-bar-danger hidden"></div>
</div>
<small class="password-error text-danger"> </small>
</div>
</div>
<div class="form-group">
<label class="control-label col-sm-3" for="confirm-password-input"> Confirm password </label>
<div class="col-sm-6">
<input name="confirm_password" type="password" id="confirm-password-input" class="form-control" autocomplete="off" data-cy="" value="" placeholder="">
</div>
</div>
<div class="row">
<div class="col-sm-offset-3 col-sm-9">
<div class="">
</div>
<div class="checkbox">
<label>
<input type="checkbox" name="provider_tos_signature" class="" value="true">
<span class="word-wrap">I agree to the PCCP, LLC <a href="/portal/legal_documents/provider_tou" target="_blank">Terms of Use</a></span>
</label>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-offset-3 col-sm-9">
<div class="">
</div>
<div class="checkbox">
<label>
<input type="checkbox" name="tos_signature" class="" value="true">
<span class="word-wrap">I agree to the portal <a href="/portal/legal_documents/portal_tou" ,="" target="_blank">Terms of Use</a></span>
</label>
</div>
</div>
</div>
<div class="row" data-cy="privacyPolicy">
<div class="col-sm-offset-3 col-sm-6 small">
<br> I acknowledge that my personal information will be used and disclosed as set forth in the portal <a href="/portal/legal_documents/portal_pp" target="_blank">Privacy Policy</a> and the PCCP, LLC
<a href="/portal/legal_documents/provider_pp" target="_blank">Privacy Policy</a>.
</div>
</div>
<br>
<div class="row">
<div class="col-sm-offset-3 col-sm-6">
<button class="btn btn-lg btn-primary btn-block" type="submit" data-cy="activateAccountButton">Activate account</button>
</div>
</div>
</form>
Text Content
Login to your PCCP, LLC portal account } WELCOME, ANN SCARLETT PLEASE CHOOSE A PASSWORD TO ACTIVATE YOUR PORTAL ACCOUNT Email address ahenry4@brighthousefinancial.com Not your email address? If you are an associate of Ann Scarlett and would like a PCCP, LLC portal account, please contact us at Inquiry@pccpllc.com or 1 (866) PCCP-LLC. Choose a password Confirm password I agree to the PCCP, LLC Terms of Use I agree to the portal Terms of Use I acknowledge that my personal information will be used and disclosed as set forth in the portal Privacy Policy and the PCCP, LLC Privacy Policy. Activate account About PCCP, LLC Inquiry@pccpllc.com ∙ 1 (866) PCCP-LLC Inquiry@pccpllc.com 1 (866) PCCP-LLC © 2022 PCCP, LLC ∙ Legal and privacy powered by Juniper Square © 2022 PCCP, LLC ∙ Legal and privacy powered by Juniper Square