case decision digest order form - pennsylvania order form.pdf · please complete, print and mail...

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Please complete, print and mail this form with your check payable to the "Commonwealth of Pennsylvania" to: Pennsylvania Insurance Department Administrative Hearings Office Attn: Hearings Administrator 901 North Seventh Street, Suite 200 Harrisburg, PA 17102 (717) 783-2126 Name: Company: Address: Email Address: Available Digest Subscriptions For each desired product, please click on the appropriate down arrow and select your desired delivery format. A digest selected in Word format will be sent as an email attachment. All digest subscribers receive quarterly updates for the digests they select (as available) at no additional charge. Automobile Policy Terminations (Act 68) @ $90/yr: Homeowner Policy Terminations (Act 205) @ $40/yr: Agency Terminations (Act 143) @ $40/year: Please select the desired delivery format for updates: Case Decision Digests Order Form Auto CAT Fund Digest @ $25/year: Practice and Procedure Digest @ $90/year: Phone Number:

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Page 1: Case Decision Digest Order Form - Pennsylvania Order Form.pdf · Please complete, print and mail this form with your check payable to the "Commonwealth of Pennsylvania" to: Pennsylvania

Please complete, print and mail this form with your check payable to the "Commonwealth of Pennsylvania" to:

Pennsylvania Insurance DepartmentAdministrative Hearings Office Attn: Hearings Administrator 901 North Seventh Street, Suite 200Harrisburg, PA 17102(717) 783-2126

Name:

Company:

Address:

Email Address:

Available Digest SubscriptionsFor each desired product, please click on the appropriate down arrow and select your desired delivery format. A digest selected in Word format will be sent as an email attachment. All digest subscribers receive quarterly updates for the digests they select (as available) at no additional charge.

Automobile Policy Terminations (Act 68) @ $90/yr:

Homeowner Policy Terminations (Act 205) @ $40/yr:

Agency Terminations (Act 143) @ $40/year:

Please select the desired delivery format for updates:

Case Decision Digests Order Form

Auto CAT Fund Digest @ $25/year:

Practice and Procedure Digest @ $90/year:

Phone Number: