You may use this form if you have forgotten your NetID password. Print this form, fill in the information, and fax it to 202-687-1162.

Note that this password reset will result in a temporary password that is valid for only a 72-hour period during which you must create a permanent password. Specific steps to do this will be sent to the email address listed below.

1. My NetID: ______________________

2. Last Name:_______________________ First Name:_____________________ MI: ___

3. Daytime Phone Number: ______ - ______- ________

4. Email Address: _____________________________________________________
Please write leglibly as we will write you at this address once the request is completed.

5. Check here: ____ Please reset my NetID password.

6. Identification:
Make a photocopy of a government-issued photo ID card--such as a driver's license or passport--with all of its accompanying information such as name and address on this sheet or send it on a separate sheet of paper. Please make the photocopy on the lightest setting or "photo" setting. Requests cannot be processed without a valid, legible photo ID.

Signature: ________________________________ Date: __________________

Note: DO NOT include your Social Security Numbers on this form!