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PERSONAL INFORMATION |
![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
Firm Name: ![-- If registering as a private individual enter your name in both the Firm Name and Contact fields. If registering as a private individual enter your name in both the Firm Name and Contact fields.](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/img/info.gif) |
![-- If registering as a private individual enter your name in both the Firm Name and Contact fields. If registering as a private individual enter your name in both the Firm Name and Contact fields.](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/img/info.gif) |
You must enter data for every field marked with a
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If you are registering as a private individual,
i.e. not as a member of a group, firm, or organization,
enter your name in both the Firm Name and
Contact Person rows.
Domestic addresses must include City,
State,
and Zip.
International addresses must include City,
Postal Code,
'OTHER' in the State field, and
Province/Country information on the 2nd Address line.
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Contact Person: |
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Address: |
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City |
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State |
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Zip/Postal Code: |
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Phone Number: |
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
E-Mail Address: ![--A link to the Quarterly invoice will be sent to the email address specified here. Additional email address(es) may be entered using the "Sign up for Paperless Statement/Invoice" option under "Manage My PACER Account". A link to the Quarterly invoice will be sent to the email address specified here. Additional email address(es) may be entered using the "Sign up for Paperless Statement/Invoice" option under "Manage My PACER Account".](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/img/info.gif) |
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Confirm E-Mail Address: |
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
ACCOUNT TYPE INFORMATION |
![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
Which best describes the individual or organization registering for this account? |
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Commercial accounts must enter a business tax
identification number.
If this account is being registered as a Government Agency
and the email does not end in .gov, .mil or .us,
this account will be defaulted to a Private account until
the PACER Service Center has been contacted at (800) 676-6856 to
verify eligibility.
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Federal Tax ID:
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
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Select the jurisdiction in which the
attorney has been appointed to the CJA Attorney Panel.
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
CREDIT CARD INFORMATION
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
Use address information above
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This section is optional.
For same day registration, we will validate the credit card
information you provide here.
The credit card will not actually be charged for
this authorization. Once your card has been approved,
you will receive a message at the email address entered above
that contains instructions for retrieving your new PACER login
and password.
Credit cards issued by a bank in a country that does not support
the AVS system can not be used to register for same day access.
Please submit your registration request without the credit card
information to receive your account by US Mail.
By entering information in this section, you
agree to have any charges accrued
by this account billed to the credit card provided here.
Debit cards are also accepted. Those entering debit cards
in this section should be aware that non sufficient funds
charges apply if funds are not available when charged.
Users should consider carefully the choice of providing
a debit card.
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Card Holder Name: |
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Address: |
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City: |
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State: |
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Zip: |
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Card Type: |
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Card Number: |
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Expiration Date: |
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
PASSWORD SECURITY INFORMATION
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
Security Question: |
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You may use the default security question or create
another question that is meaningful to you.
We will use this information to verify your identity
in the event you forget your password. To protect
your account make sure the Security Question
and Answer you select is easy for you to
remember but difficult for others to guess.
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Answer: |
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Your Date of Birth: |
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
FEE INFORMATION
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
There is no registration fee. However, the Judicial Conference
of the United States has established a fee for access to
information in PACER. All registered users will be charged
as follows:
- Use of web-based PACER systems will generate an
$.10 per page charge.
- Audio files of court hearings retrieved via PACER will generate a $2.40 per file charge.
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
ACKNOWLEDGMENT OF POLICIES AND PROCEDURES (05/17/2010)
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
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![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
SUBMIT COMPLETED FORM |
![](https://webarchive.library.unt.edu/web/20121014022848im_/https://www.pacer.gov/images/blank.gif) |
If you completed the CREDIT CARD INFORMATION
and PASSWORD SECURITY INFORMATION sections,
you will receive instructions
at the email address entered above for retrieving your new
PACER login and password after the credit card has been
approved.
Otherwise, you will receive your login and password in the mail
within a week. For security reasons, logins and
passwords can not be emailed, faxed or given over the phone.
If you have any questions, call the PACER Service Center at
(800) 676-6856.
Note: We protect the security of your information during transmission using Secure Sockets Layer (SSL) software, which encrypts information you submit.
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