DISKETTE ORDER FORM
IF YOU ARE UNABLE TO DOWNLOAD THE FILES FROM THE DEPARTMENTS 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: | ______________________________________ |
| PERSONS NAME: | ______________________________________ |
| TITLE: | ______________________________________ |
| STREET OR PO BOX: | ______________________________________ |
| CITY: | ______________________________________ |
| STATE: | _________________________ ZIP:_________ |