NO OBLIGATION
By completing and submitting any application form you are only applying for insurance coverage,
pending an underwriting review. No contract of insurance is created by your completion of this
request. You are under no obligation to purchase automobile insurance from Tri-State Consumer
Insurance Company.
SERVICE
If you need assistance a representative is available 24 hours a day. Call 800-JOIN NOW (564-6669)
INFORMATION RETRIEVAL
If you need to leave the site for any reason, the information that you have input will be saved and
accessible on this computer for 60 days by referencing your telephone number and application number.
2007 All Rights
Reserved. Tri-State Consumer Insurance Company, a division of Tri-State
Consumer Inc., 575 Jericho Turnpike, Jericho, NY 11753.