Download Auto Form

Download Application

To print a copy of the application form please click below. You can return the completed application by mail:

Tri-State Consumer Insurance Company
575 Jericho Turnpike
Jericho, NY 11753

Or, simply fax it to us at (516) 827-4696.

To find out about the status of your application, call us at 1-800-JOIN-NOW or email us at service@tscinsurance.com

You will need the Adobe Acrobat Reader to view or print these files. Fortunately, if you are using Netscape Communicator 4.0 or Microsoft Internet Explorer 4.0, the reader is built into your web browser and you can view or print PDF's just by clicking on the PDF you wish to examine. If you wish to download the file from Internet Explorer, point your mouse over the Application and right click and select "Save Target As...".

If you wish to download the file from Netscape, point your mouse over the Application and right click and select "Save Link As...". If you are not using Netscape Communicator 4.0 or Microsoft Internet Explorer 4.0, you will need to download and install the free Adobe Acrobat Reader.

For a free download of Adobe Acrobat Reader, click the image below.