BUSINESS CITADEL™ INQUIRY FORM

By completing and submitting the form below, you are requesting to receive information on Business Citadel representation rates and benefits. There is no obligation associated with this information request. Some businesses may be deemed ineligible to enroll in Business Citadel plans due to certain criteria such as having been named a defendant in multiple lawsuits or otherwise being determined to have the likelihood of being named a defendant in lawsuits.


Request information on Business Citadel plans:

Mandatory fields are marked*


Contact information:  
Business name:*
Business address:*  
Street address
City, state, and zip code:
Mailing address (if different than street address):  
City, state, and zip code:
   
Business information:  
How many locations does your business have?*
Structure of business:*
Annual gross sales:
Types of products or services your business offers:*
   
Legal history:  
Please briefly describe the nature of the lawsuit(s)/causes of action/facts alleged:
 
Excluding small-claims cases, have any of the principles (owners) of your business ever been named a defendant in a civil action? (For corporations, the company's officers and directors shall be considered "principles").*
   
Approximate legal expenses incurred in the last two years:
   
If known, please briefly describe the types of legal services you foresee your business requiring in the next 12-months:
 

Upon meeting minimal eligibility criteria, you will receive a log-in username/password by email which you may use to view plan coverages and costs. Please allow up to 10-business days. If you have a current pressing legal matter, please contact us.