DISKETTE ORDER FORM
IF YOU ARE UNABLE TO DOWNLOAD THE FILES FROM THE DEPARTMENT'S WEBSITE AND YOU DO NOT HAVE ACCESS TO INTERNET E-MAIL, YOU CAN OBTAIN A DISKETTE CONTAINING BOTH THE LOTUS 1.2.3® AND MICROSOFT EXCEL® VERSIONS OF THE INSURANCE AVAILABILITY SURVEY AND FREE TRADE ZONE UPDATE WORKSHEET.
TO OBTAIN THE DISKETTE, FILL OUT THE INFORMATION BELOW AND MAIL TO:
NEW YORK INSURANCE DEPARTMENT
ATTN: PROPERTY BUREAU
MARS-IA
25 BEAVER STREET
NEW YORK, NY 10004
| COMPANY NAME: | ______________________________________ |
| PERSON'S NAME: | ______________________________________ |
| TITLE: | ______________________________________ |
| STREET OR PO BOX: | ______________________________________ |
| CITY: | ______________________________________ |
| STATE: | _________________________ ZIP:_________ |