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| 2006 Application | Medical Malpractice Liability Insurance Premium Assistance Fund | |
| Applications should have been filed online no later than 5 p.m. EDT Friday, August 24, 2007 to have been considered timely | ||
| Instructions | ||
| IMPORTANT: | One of the requirements for receiving this subsidy was the submission of a State of New Jersey W-9 Questionaire Form. This questionaire must have been completed, signed and returned to the New Jersey Department of Banking and Insurance BEFORE you or your designated payee could receive the subsidy. Complete the W-9 Questionnaire, and fax the form to 609-777-0019. The W-9 form cannot be filed online. The person who will receive the 2006 subsidy payment (either you or your designated payee) should have submitted the W-9 Questionnaire form no later than Friday, August 24, 2007. |
PLEASE NOTE: |
Even if the Department of Banking and Insurance determines that you are eligible
for the 2006 subsidy, the State Treasurer will not process our
request for a payment to you (or your designated payee) without a
W-9 on file with their office. |
| More Information | View our Frequently Asked Questions | |
| MMLIPA
Fund NJ Department of Banking and Insurance PO Box 325 Trenton, NJ 08625-0325 |
Telephone: 609-292-3100 Fax: 609-777-0019 |
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OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey. |  |
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| Copyright © 2007,
State of New Jersey New Jersey Department of Banking and Insurance |
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