Customer Portal Support Name First Last Phone Number Email DHS Case ID (if available) Customer Portal Username Date and time issue was experienced Date and time issue was experienced: Date Date and time issue was experienced: Time Check any warning messages you saw: Oops You have a duplicate account Your account has been locked Someone else is accessing your account H2 No warning message/other warning message Check what you were trying to do: Create an account Log into an account Check to see if you have an account Reset a username or password Apply for a new program Renew a program Report a change Other Describe your customer portal issue CAPTCHA What code is in the image? Enter the characters shown in the image. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Leave this field blank