The Contact Information page is used to collect your contact information
and will be associated with the insurer(s) you have set up in PLCR. Note:
PLCR only allows for the entry of only one contact.
To add your contact information to PLCR you may either choose to use
the contact information you established when setting up your account,
or type in new contact information.
|
Type |
Type indicates your name or your company's
name. Select
Individual or Entity from the drop down box as appropriate. |
|
First Name |
Your given name if the Type is Individual. |
|
MI |
Your middle name if the Type is Individual. |
|
Last Name |
Your last name if the Type is Individual. |
|
Entity Name |
Your company's if the Type is Entity. |
|
Address |
The street address of your business. |
|
City |
The city in which your business is located. |
|
State |
The state in which your business is located. |
|
ZIP/Postal Code |
The ZIP/Postal Code address in which your business
is located. |
|
Phone Number |
A phone number where you can be reached when
using the application. |
|
Extension |
Your phone extension, if applicable. |
|
Fax |
Your business fax number. |
|
Email |
The email address you use at your company. |