Zenith Online Account Registration – Policyholders Additional User Remove Additional User First Name * Job Title * Phone Number * (Please DO NOT use Toll Free Number) Last Name * Email Address * Mobile Number Online Account Options Please select at least one option * VIEW MY POLICY ON MYZENITH MANAGE USERS FOR MY POLICY ACCESS ZENITH SOLUTION CENTER® Online Account Options Please select at least one option * ACCESS ZENITH SOLUTION CENTER® Please provide the following information to request online account access. All new accounts are typically set up within one business day. We'll send two emails with your account user ID, password, and login instructions. Note: MyZenith contains employee claims information and can only be requested by an owner, officer, or principal of the company. The account setup process allows an owner, officer, or principal to designate additional employees to have access. Access to anyone except an authorized employee of the company is strictly prohibited. No third party/contractor access is allowed. YES, I am an owner, officer, or principal of the company. (Allows access to MyZenith, Manage Users and Zenith Solution Center®; subject to approval) NO, I am NOT an owner, officer, or principal of the company. (Allows access to Zenith Solution Center®; subject to Zenith approval and then set up by the owner, officer, or principal of the company) Company Information Company Name or DBA * Address Line 1 * Address Line 2 City * State * - Select State - ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Do you have an existing account for any of Zenith's online applications? * Yes No Please provide your User ID * Contact Information First Name * Job Title * Phone Number * (Please DO NOT use Toll Free Number) Last Name * Email Address * Mobile Number Online Account Options Please select at least one option * VIEW MY POLICY ON MYZENITH: Request access to view your workers' compensation policy information, including employee claim information. MANAGE USERS FOR MY POLICY: The account administrator role allows you to add and modify user IDs and reset passwords for the users you would like to grant access to your policy information on MyZenith, including employee claim information. If you wish to be the account administrator, please read the Policyholder Administrator Responsibilities Agreement, indicate your acceptance of the terms by marking the checkbox, and email the completed agreement to ecommerce@thezenith.com. Note: Each policyholder may assign up to two account administrators. ACCESS ZENITH SOLUTION CENTER®: Get comprehensive risk management, safety, and HR resources specific to your industry. Online Account Options ACCESS ZENITH SOLUTION CENTER® Policy Information Primary Policy # (7 digits starting with M; 10 digits starting with C, J, Z; or 11 digits starting with CFP) * Policy Effective Date (mm/dd/yyyy) * Email Preference On occasion, Zenith emails important information such as regulatory changes, safety and health initiatives, and claim servicing matters to the email you provided. I DON'T want to receive emails. Add Additional Users Would you like to give additional users access to your policy information and/or Zenith Solution Center®? * Add Additional Users Yes No I've read and accept the terms of the Principal User Agreement. * I Accept