sb-onlineaccess.3racacpsi.com
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129.213.130.221
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URL:
https://sb-onlineaccess.3racacpsi.com/
Submission: On March 19 via api from US — Scanned from US
Submission: On March 19 via api from US — Scanned from US
Form analysis 1 forms found in the DOM
POST /
<form action="/" autocomplete="off" id="SignInForm" method="post" novalidate="novalidate">
<div id="troublesigin"></div>
<div id="siginDetailsDiv">
<h1 class="h4 text-center font-adventor">Access your ACA forms online</h1>
<p class="text-center small">You will receive a One Time Access (OTA) code to the below email address.</p>
<div class="mb-3">
<label for="EmailAddress" class="form-label mb-0 font-adventor">Email Address</label> <small class="text-muted d-block mb-2">Enter your email address where you received the online access link</small>
<div class="input-group">
<span class="input-group-text pt-2 position-absolute bg-transparent border-0 z-index-2" id="addon-wrapping">
<svg xmlns="http://www.w3.org/2000/svg" height="24px" viewBox="0 0 24 24" width="24px" fill="#000000">
<path d="M0 0h24v24H0V0z" fill="none"></path>
<path d="M22 6c0-1.1-.9-2-2-2H4c-1.1 0-2 .9-2 2v12c0 1.1.9 2 2 2h16c1.1 0 2-.9 2-2V6zm-2 0l-8 4.99L4 6h16zm0 12H4V8l8 5 8-5v10z" fill="#989898" class="fill"></path>
</svg>
</span> <input class="form-control ps-5" id="loginEmailAddress" maxlength="50" name="EmailAddress" placeholder="Email Address" tabindex="1" type="text" value="">
</div>
</div>
<div class="mb-3">
<label for="SSN" class="form-label mb-0 font-adventor">Last 4 digits of SSN</label> <small class="text-muted d-block mb-2">Enter the last 4 digits of your SSN</small>
<div class="input-group">
<span class="input-group-text pt-2 position-absolute bg-transparent border-0 z-index-2" id="addon-wrapping">
<svg xmlns="http://www.w3.org/2000/svg" height="24px" viewBox="0 0 24 24" width="24px" fill="#000000" onclick="showPassword()">
<path d="M0 0h24v24H0V0z" fill="none"></path>
<path
d="M12 6c3.79 0 7.17 2.13 8.82 5.5C19.17 14.87 15.79 17 12 17s-7.17-2.13-8.82-5.5C4.83 8.13 8.21 6 12 6m0-2C7 4 2.73 7.11 1 11.5 2.73 15.89 7 19 12 19s9.27-3.11 11-7.5C21.27 7.11 17 4 12 4zm0 5c1.38 0 2.5 1.12 2.5 2.5S13.38 14 12 14s-2.5-1.12-2.5-2.5S10.62 9 12 9m0-2c-2.48 0-4.5 2.02-4.5 4.5S9.52 16 12 16s4.5-2.02 4.5-4.5S14.48 7 12 7z"
fill="#989898" class="fill"></path>
</svg>
</span> <input class="form-control ps-5" id="loginSSN" maxlength="4" name="SSN" onkeypress="return isNumber(event)" pattern="^[0-9]*$" placeholder="Enter last 4 digits of SSN" tabindex="2" type="password" value="">
</div>
</div>
<div id="btntroubleDiv" class="mb-3">
<div colspan="2" class="spacer20">
<a href="javascript:void(0);" class="link" id="btntrouble" onclick="fnTrouble();">Trouble Signing In?</a>
</div>
</div>
<div class="text-center my-3">
<button data-bb-handler="delete" type="button" class="btn btn-primary text-white fw-bold px-3 rounded" onclick="ContinuetoOTP()" id="continuetoLoginbtn">Continue <span class="spinner-border spinner-border-sm" role="status" aria-hidden="true"
id="continuetoLoginspinner" style="display:none;"></span></button>
<ul class="list-unstyled mt-3 p-3 rounded shadow-sm w-100 bottom-0 start-0 bg-light_1 d-lg-none text-start">
<li class="d-flex mb-2">
<div class="pe-2">
<svg xmlns="http://www.w3.org/2000/svg" height="24" width="24">
<path
d="M12 22q-2.075 0-3.9-.788-1.825-.787-3.175-2.137-1.35-1.35-2.137-3.175Q2 14.075 2 12t.788-3.9q.787-1.825 2.137-3.175 1.35-1.35 3.175-2.138Q9.925 2 12 2q1.625 0 3.075.475 1.45.475 2.675 1.325L16.3 5.275q-.95-.6-2.025-.938Q13.2 4 12 4 8.675 4 6.338 6.337 4 8.675 4 12t2.338 5.663Q8.675 20 12 20q3.325 0 5.663-2.337Q20 15.325 20 12q0-.45-.05-.9t-.15-.875L21.425 8.6q.275.8.425 1.65.15.85.15 1.75 0 2.075-.788 3.9-.787 1.825-2.137 3.175-1.35 1.35-3.175 2.137Q14.075 22 12 22Zm-1.4-5.4-4.25-4.25 1.4-1.4 2.85 2.85 10-10.025 1.4 1.4Z">
</path>
</svg>
</div> This secure portal enables you to view and download your ACA Forms 1095-B/1095-C/MA1099-HC at any time
</li>
<li class="d-flex text-dark">
<div class="pe-2 ">
<svg xmlns="http://www.w3.org/2000/svg" height="24" width="24">
<path
d="M12 22q-2.075 0-3.9-.788-1.825-.787-3.175-2.137-1.35-1.35-2.137-3.175Q2 14.075 2 12t.788-3.9q.787-1.825 2.137-3.175 1.35-1.35 3.175-2.138Q9.925 2 12 2q1.625 0 3.075.475 1.45.475 2.675 1.325L16.3 5.275q-.95-.6-2.025-.938Q13.2 4 12 4 8.675 4 6.338 6.337 4 8.675 4 12t2.338 5.663Q8.675 20 12 20q3.325 0 5.663-2.337Q20 15.325 20 12q0-.45-.05-.9t-.15-.875L21.425 8.6q.275.8.425 1.65.15.85.15 1.75 0 2.075-.788 3.9-.787 1.825-2.137 3.175-1.35 1.35-3.175 2.137Q14.075 22 12 22Zm-1.4-5.4-4.25-4.25 1.4-1.4 2.85 2.85 10-10.025 1.4 1.4Z">
</path>
</svg>
</div> You will receive email notifications if your employer files any corrections to your ACA Forms
</li>
</ul>
</div>
</div>
<div id="generateOtp" style="display:none">
<h1 class="h4 text-center font-adventor">Access your ACA forms online</h1>
<p class="text-center small">We have sent the One Time Access Code(OTA) to your email address</p>
<div class=" text-center ">
<label for="OTP" class="form-label mb-0 font-adventor">One Time Access (OTA) Code:</label> <small class="text-muted mb-2 d-block">To verify, enter the One Time Access Code below </small>
<div class="input-group">
<span class="input-group-text pt-2 position-absolute bg-transparent border-0 z-index-2" id="addon-wrapping">
<svg xmlns="http://www.w3.org/2000/svg" height="24px" viewBox="0 0 24 24" width="24px" fill="#000000">
<path d="M0 0h24v24H0V0z" fill="none"></path>
<path
d="M12 6c3.79 0 7.17 2.13 8.82 5.5C19.17 14.87 15.79 17 12 17s-7.17-2.13-8.82-5.5C4.83 8.13 8.21 6 12 6m0-2C7 4 2.73 7.11 1 11.5 2.73 15.89 7 19 12 19s9.27-3.11 11-7.5C21.27 7.11 17 4 12 4zm0 5c1.38 0 2.5 1.12 2.5 2.5S13.38 14 12 14s-2.5-1.12-2.5-2.5S10.62 9 12 9m0-2c-2.48 0-4.5 2.02-4.5 4.5S9.52 16 12 16s4.5-2.02 4.5-4.5S14.48 7 12 7z"
fill="#989898" class="fill"></path>
</svg>
</span>
<input class="form-control ps-5" id="OneTimeAccessCode" maxlength="6" name="OTP" placeholder="One Time Access Code" type="text" value="">
</div>
</div>
<div class="text-center mb-3 mt-2 small text-muted"> Didn't receive a code? <a class="text-center fw-500 text-danger" onclick="SendOTAByEmail(true,'')" id="resendloginOTAbtn">Resend </a>
<span id="btnLoginEmailText"> (in <span id="txtLoginEmailResend">47</span>) seconds.</span>
</div>
<div class="text-center">
<button type="button" class="btn btn-primary text-white fw-bold px-2 rounded" onclick="CheckOTA()" id="submitloginOTAbtn">Submit <span class="spinner-border spinner-border-sm" role="status" aria-hidden="true" id="submitloginOTAbtnspinner"
style="display:none;"></span></button>
</div>
</div>
<div id="recoveryEmailandPhoneNumber" style="display:none">
<div>
<p class="fw-bold h6 mb-3">Set up Recovery Email Address and Phone Number</p>
<p class="small mb-1">Adding a recovery phone number and email address will allow you to easily recover your account if you forget your credentials</p>
<p class="small">You can select, skip for now if you would prefer to add this information later.</p>
<div>
<div class=" my-3 align-items-center justify-content-between card flex-row p-3 shadow border-0" id="beforeEditrecoveryEmailAddress" style="display:none">
<div class="d-flex align-items-center">
<div class="me-2 d-none d-md-block">
<div class="d-flex justify-content-center align-items-center border rounded-circle p-1">
<svg xmlns="http://www.w3.org/2000/svg" height="40" width="40">
<path
d="M6.333 33.375q-1.208 0-2.104-.896-.896-.896-.896-2.146V9.667q0-1.25.896-2.146.896-.896 2.104-.896h27.334q1.208 0 2.104.896.896.896.896 2.146v20.666q0 1.25-.896 2.146-.896.896-2.104.896ZM20 21.292 6.333 12.417v17.916h27.334V12.417Zm0-2.875 13.5-8.75h-27Zm-13.667-6v-2.75 20.666Z"
fill="#999"></path>
</svg>
</div>
</div>
<div class="d-flex align-items-center flex-column flex-md-row">
<p class="mb-0"><b>Step 1:</b><br> <small>Set Recovery Email Address </small></p>
</div>
</div>
<div class="text-center my-2 ps-md-4">
<a href="javascript:void(0)" data-bb-handler="delete" class="w-500 fw-bold px-3 rounded text-nowrap small-sm" data-bs-toggle="modal" onclick="addRecoveryEmaillAddress()">Add Email Address</a>
</div>
</div>
<div class=" my-3 align-items-center justify-content-between card flex-row p-3 shadow border-0" id="afterEditrecoveryEmailAddress" style="display:none">
<div class="d-flex align-items-center w-100">
<div class="me-2 d-none d-md-block">
<div class="d-flex justify-content-center align-items-center border rounded-circle p-1 w-100">
<svg xmlns="http://www.w3.org/2000/svg" height="40" width="40">
<path
d="M6.333 33.375q-1.208 0-2.104-.896-.896-.896-.896-2.146V9.667q0-1.25.896-2.146.896-.896 2.104-.896h27.334q1.208 0 2.104.896.896.896.896 2.146v20.666q0 1.25-.896 2.146-.896.896-2.104.896ZM20 21.292 6.333 12.417v17.916h27.334V12.417Zm0-2.875 13.5-8.75h-27Zm-13.667-6v-2.75 20.666Z"
fill="#989898"></path>
</svg>
</div>
</div>
<div class="d-flex align-items-center flex-column flex-md-row w-100">
<p class="mb-0" id="viewemailrecoverystep"><b>Step 1:</b><br> <small>Recovery Email Address </small></p>
<div class="d-flex align-content-center w-100 justify-content-between" id="viewemailrecovery">
<div><label class="fw-bold d-block small-sm">Email Address</label><label id="UpdatedRecoveryEmailAddress"></label></div>
<a onclick="EdidRecoveryEmailAddress()">
<div class="d-flex justify-content-center align-items-center border boreder-danger rounded-circle p-1">
<svg xmlns="http://www.w3.org/2000/svg" height="24" width="24"><path d="m10 21 4-4h8v4Zm-6-2h1.4l8.625-8.625-1.4-1.4L4 17.6ZM18.3 8.925l-4.25-4.2 1.4-1.4q.575-.575 1.413-.575.837 0 1.412.575l1.4 1.4q.575.575.6 1.388.025.812-.55 1.387ZM16.85 10.4 6.25 21H2v-4.25l10.6-10.6Zm-3.525-.725-.7-.7 1.4 1.4Z" fill="#989898"></path></svg>
</div>
</a>
</div>
</div>
</div>
</div>
<div class=" my-3 align-items-center justify-content-between card flex-row p-3 shadow border-0" id="beforeEditrecoveryPhonrNumber" style="display:none">
<div class="d-flex align-items-center">
<div class="me-2 d-none d-md-block">
<div class="d-flex justify-content-center align-items-center border rounded-circle p-2">
<svg xmlns="http://www.w3.org/2000/svg" height="40" width="40">
<path
d="M11.333 38.292q-1.25 0-2.145-.875-.896-.875-.896-2.125V4.708q0-1.25.896-2.125.895-.875 2.145-.875h17.334q1.25 0 2.145.875.896.875.896 2.125v30.584q0 1.25-.896 2.125-.895.875-2.145.875Zm0-7.167v4.167h17.334v-4.167ZM20 34.583q.583 0 .979-.395.396-.396.396-.98 0-.583-.396-.979T20 31.833q-.583 0-.979.396t-.396.979q0 .584.396.98.396.395.979.395ZM11.333 28.5h17.334V8.792H11.333Zm0-22.333h17.334V4.708H11.333Zm0 24.958v4.167Zm0-24.958V4.708v1.459Z"
fill="#989898"></path>
</svg>
</div>
</div>
<div class="d-flex align-items-center flex-column flex-md-row">
<p class="mb-0"><b>Step 2:</b><br> <small>Set Recovery Phone Number </small></p>
</div>
</div>
<div class="text-center my-2 ps-md-4">
<a href="javascript:void(0)" data-bb-handler="delete" class="w-500 fw-bold px-3 rounded text-nowrap small-sm" data-bs-toggle="modal" onclick="addRecoveryPhoneNumber()">Add Phone Number</a>
</div>
</div>
<div class=" my-3 align-items-center justify-content-between card flex-row p-3 shadow border-0" id="afterEditrecoveryPhonrNumber" style="display:none">
<div class="d-flex align-items-center w-100">
<div class="me-2 d-none d-md-block">
<div class="d-flex justify-content-center align-items-center border rounded-circle p-2">
<svg xmlns="http://www.w3.org/2000/svg" height="40" width="40">
<path
d="M11.333 38.292q-1.25 0-2.145-.875-.896-.875-.896-2.125V4.708q0-1.25.896-2.125.895-.875 2.145-.875h17.334q1.25 0 2.145.875.896.875.896 2.125v30.584q0 1.25-.896 2.125-.895.875-2.145.875Zm0-7.167v4.167h17.334v-4.167ZM20 34.583q.583 0 .979-.395.396-.396.396-.98 0-.583-.396-.979T20 31.833q-.583 0-.979.396t-.396.979q0 .584.396.98.396.395.979.395ZM11.333 28.5h17.334V8.792H11.333Zm0-22.333h17.334V4.708H11.333Zm0 24.958v4.167Zm0-24.958V4.708v1.459Z"
fill="#989898"></path>
</svg>
</div>
</div>
<div class="d-flex align-items-center flex-column flex-md-row w-100">
<p class="mb-0" id="viewphonerecoverystep"><b>Step 2:</b><br>Recovery Phone Number </p>
<div class="d-flex align-items-center w-100 justify-content-between" id="viewphonerecovery">
<div><label class="fw-bold d-block small-sm">Phone Number</label><label id="UpdatedRecoveryPhoneNumber"></label></div>
<a onclick="EditRecoveryPhoneNumber()">
<div class="d-flex justify-content-center align-items-center border boreder-danger rounded-circle p-1">
<svg xmlns="http://www.w3.org/2000/svg" height="24" width="24"><path d="m10 21 4-4h8v4Zm-6-2h1.4l8.625-8.625-1.4-1.4L4 17.6ZM18.3 8.925l-4.25-4.2 1.4-1.4q.575-.575 1.413-.575.837 0 1.412.575l1.4 1.4q.575.575.6 1.388.025.812-.55 1.387ZM16.85 10.4 6.25 21H2v-4.25l10.6-10.6Zm-3.525-.725-.7-.7 1.4 1.4Z" fill="#989898"></path></svg>
</div>
</a>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="text-end mt-5" id="skipforNow">
<a href="javascript:void(0)" class="text-dark fw-bold text-decoration-none" onclick="CheckIsConsentSigned()">
Skip For Now
<svg xmlns="http://www.w3.org/2000/svg" height="24" width="24"><path d="M16.5 18V6h2v12Zm-11 0V6l9 6Zm2-6Zm0 2.25L10.9 12 7.5 9.75Z"></path></svg>
</a>
</div>
</div>
<div class="text-end my-3">
<button data-bb-handler="delete" type="button" class="btn btn-primary text-white fw-bold px-4 rounded" onclick="CheckIsConsentSigned()" style="display:none" id="CheckIsFirstSigninAttempt">Continue <span class="spinner-border spinner-border-sm"
role="status" aria-hidden="true" id="CheckIsFirstSigninAttemptSpinner" style="display:none;"></span></button>
</div>
<div id="troubleDiv" class="loginRight loginRightIn" style="display:none;">
<div id="threeOption" class="OA-Checkbox">
<div class="mb-3">
<h1 class="h4 text-center font-adventor"> </h1>
<p class="small fw-bold">Trouble signing in? Choose one of the following Option!</p>
<div class="form-check mb-1">
<input class="form-check-input" id="TroubleSigin" name="TroubleSigin" onclick="dontHaveLoginAccess()" type="radio" value="True">
<input type="radio" class="form-check-input" id="IDontHaveAccess" name="TroubleType" value="IDontHaveAccess" onchange="fnRecoveryFlow()">
<label class="form-check-label" for="IDontHaveAccess"> I don’t have access to my Login Email Address </label>
</div>
<div class="form-check mb-1">
<input type="radio" class="form-check-input" id="ForgetEmail" name="TroubleType" onchange="fnRecoveryFlow()">
<label class="form-check-label" for="ForgetEmail"> I forgot my Login Email Address </label>
</div>
<div class="form-check mb-1">
<input type="radio" class="form-check-input" id="LoginIssue" name="TroubleType" onchange="fnRecoveryFlow()">
<label class="form-check-label" for="ForgetEmail"> I have a different Login Issue </label>
</div>
</div>
<div id="recoveryFlow" style="display:none;"></div>
<div id="Divloginissue" style="display:none;">
<div class="mt-2">
<small class="text-muted d-block mb-2"> Please contact your Employer/Payer for further assistance. </small>
</div>
</div>
</div>
<div class="skipBtn mt-3" id="backbtnDiv">
<div id="BackDiv">
<div class="spacer25"></div>
<a href="javascript:void(0);" class="link ml-1" id="btntrouble" onclick="fnBackToSignin();">Back to Sign In</a>
</div>
<!--<button type="button" class="btn btn-primary text-white fw-bold rounded disabled" id="btnOTPAccess" tabindex="4" onclick="VerifyDetails()">
Continue-->
<!--</button>-->
</div>
</div>
</form>Text Content
This website is for testing and development only. For live site, please visit X THIS WEBSITE IS FOR TESTING AND DEVELOPMENT ONLY FOR LIVE SITE, PLEASE VISIT Please enter the password to use the testing site Password is required Continue This website is for testing and development only. For live site, please visit www.ExpressACAForms.comX * This secure portal enables you to view and download your ACA Forms 1095-B/1095-C/MA1099-HC at any time * You will receive email notifications if your employer files any corrections to your ACA Forms ACCESS YOUR ACA FORMS ONLINE You will receive a One Time Access (OTA) code to the below email address. Email Address Enter your email address where you received the online access link Last 4 digits of SSN Enter the last 4 digits of your SSN Trouble Signing In? Continue * This secure portal enables you to view and download your ACA Forms 1095-B/1095-C/MA1099-HC at any time * You will receive email notifications if your employer files any corrections to your ACA Forms ACCESS YOUR ACA FORMS ONLINE We have sent the One Time Access Code(OTA) to your email address One Time Access (OTA) Code: To verify, enter the One Time Access Code below Didn't receive a code? Resend (in 47) seconds. Submit Set up Recovery Email Address and Phone Number Adding a recovery phone number and email address will allow you to easily recover your account if you forget your credentials You can select, skip for now if you would prefer to add this information later. Step 1: Set Recovery Email Address Add Email Address Step 1: Recovery Email Address Email Address Step 2: Set Recovery Phone Number Add Phone Number Step 2: Recovery Phone Number Phone Number Skip For Now Continue Trouble signing in? Choose one of the following Option! I don’t have access to my Login Email Address I forgot my Login Email Address I have a different Login Issue Please contact your Employer/Payer for further assistance. Back to Sign In SET RECOVERY EMAIL ADDRESS Enter the recovery email address below and click Verify. A One-Time Access Code will be sent to this email address for verification. We recommend using your personal email address. Recovery Email Address: One Time Access Code Enter the One Time Access Code below to verify your recovery email. Didn't receive a code? Resend (in 47) Cancel Verify Continue SET RECOVERY PHONE NUMBER Enter the recovery phone number below and click Verify. A One-Time Access Code will be sent to this phone number for verification. We recommend using your current phone number. One Time Access Code Enter the One Time Access Code below to verify your recovery phone number. Didn't receive a code? Resend (in 47) Close Verify Continue