public.govdelivery.com Open in urlscan Pro
2001:18c8:17f:fc75:20:1:1:2  Public Scan

Form analysis
1 forms found in the DOM

POST /accounts/USSSA/subscriber/qualify

<form action="/accounts/USSSA/subscriber/qualify" accept-charset="UTF-8" method="post"><input name="utf8" type="hidden" value="✓"><input type="hidden" name="authenticity_token"
    value="H8Q9sw1AbPOkZO7V27U9gVVQQY7gdtbSTFeAZfzLoJ5YocfSCcm300ZOih6YeTZ+TgBTG3n6ppVtdQ4IwexZYQ==">
  <fieldset id="quick_subscribe_new">
    <legend>
      <h1> Message Updates </h1>
    </legend>
    <div id="quick_subscribe_new_instructions">
      <p>To sign up for updates or to access your subscriber preferences, please enter your contact information below.</p>
    </div>
    <ol class="form">
      <li>
        <label for="subscription_type">Subscription Type</label>
        <div class="input_group">
          <select name="subscription_type" id="subscription_type">
            <option value="email">Email</option>
            <option value="phone">Cell Phone Number</option>
          </select>
        </div>
      </li>
      <li class="wireless_fields" style="display: none">
        <label for="phone"><img class="required" alt="" aria-hidden="true" src="https://content.govdelivery.com/images/required.gif">Cell Phone Number</label>
        <div class="input_group">
          <select name="country_code_display" id="country_code_display" disabled="disabled" aria-label="Country code">
            <option value="1 (US)">1 (US)</option>
            <option value="1">1</option>
          </select>
          <input type="hidden" name="country_code" id="country_code" value="1" title="Country code">
          <input type="tel" name="phone" id="phone" value="" class="medium wireless_text_field" title="Provide your full phone number without country code or characters such as a dash or space. e.g 5555550123"
            oninvalid="setCustomValidity('Provide your full phone number without country code or characters such as a dash or space. e.g 5555550123')" pattern="[0-9]{10}"
            oninput="if (validity.patternMismatch) { setCustomValidity('Provide your full phone number without country code or characters such as a dash or space. e.g 5555550123'); } else { setCustomValidity(''); }" disabled="disabled">
        </div>
      </li>
      <li class="email_fields" style="display: block">
        <label for="email"><img class="required" alt="" aria-hidden="true" src="https://content.govdelivery.com/images/required.gif">Email Address</label>
        <input type="email" name="email" id="email" value="" class="long email_text_field" aria-describedby="errorExplanation" required="required">
      </li>
    </ol>
    <span aria-hidden="aria-hidden" style="display: none">
      <label for="name"><img class="required" alt="" aria-hidden="true" src="https://content.govdelivery.com/images/required.gif">Name</label>
      <input type="text" name="name" id="name" value="" aria-disabled="true" autocomplete="off">
    </span>
    <div class="button_panel">
      <input type="submit" name="commit" value="Submit" data-disable-with="Submit"><input type="button" value="Cancel" class="cancel_button">
    </div>
  </fieldset>
</form>

Text Content

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Stay connected with Social Security


MESSAGE UPDATES

To sign up for updates or to access your subscriber preferences, please enter
your contact information below.

 1. Subscription Type
    Email Cell Phone Number
 2. Cell Phone Number
    1 (US) 1
 3. Email Address

Name


Your contact information is used to deliver requested updates or to access your
subscriber preferences. 

By entering your cell phone number, you agree to receive automated text messages
from the Social Security Administration when information is updated.  Your
carrier’s standard message and data rates apply.  

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