Account Request

Account Request Page

Please provide the required information below to request access to the Massachusetts Pawn Shop/Jewelry/2nd-Hand Sales Reporting System
Note: Highlighted fields are required.

I am requesting access as an authorized member of a Law Enforcement Agency.

Name (First, MI, Last):

E-Mail Address:

Business Name:

Store No.:

Confirm E-Mail Address:

Business Adress:

Password:

Confirm Password:

City:

State:

ZIP:

Phone:

Main Contact:

Main Contact Phone:

Fax:

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