StarStone National Insurance Company

StarStone Online Services Registration Form

Report Payroll, Make Payments and View Statements
Policyholder Information
(as shown on policy)
* Policy Number :  
* Insured Name :  
* Federal Employers Identification Number :  
Individual authorized to administer access to the StarStone Online Services
* Email Address :
(Your Email Address is your User ID)
* First Name :  
* Last Name :  
* Phone :
Ext :
 
† By clicking the box I agree, in the absence of my written signature, this is the electronic representation of my signature and confirmation that information provided above are correct. I further understand that this electronic signature will have the same legally-binding effect as signing my signature using pen and paper.