If you are currently a participant in the NLADA Insurance Program, and if the expiration date of your current policy is less than 120 days away, you will need to submit a Renewal Application in order to continue your coverage for another year.

Download the Insurance Renewal Application in Word Format (msword, 44 Kb) from this site.

Download the Insurance Renewal Application in PDF Format (pdf, 42 Kb) from this site.

Please follow the instructions on Page 1 and mail or fax to:

NLADA Insurance Program
1140 Connecticut Ave. NW, Suite 900
Washington, DC 20036
(202) 452-9879 Fax
Or, call (800) 725-4513 (Toll-free), (202) 452-9870 with questions.

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