Legal Assist: Agencies

Please note: If your question relates to a threat, allegation, lawsuit, or claim that's likely to be covered under a Brotherhood Mutual insurance policy, don't complete this form. Use this link instead.

Required fields are marked with an asterisk

Email confirmation to(required)

Ministry Name(required)

Please do not enter agency name here

Ministry City(required)

Ministry State(required)

Ministry Contact Name(required)

Ministry Contact Title(required)

(e.g., Senior Pastor, Executive Director, Administrator, Board Member, etc.)

Ministry Contact Email(required)

Please do not enter an agency email

Ministry Contact Phone

CMP Policy or Quote Number(required)

Please include "M" before the quote number. If no policy or quote number exists, type N/A.

Agency Name(required)

Agency Number(required)

Agency Contact Name(required)

Agency Contact Email(required)

Additional Agency Emails (optional)

Add the email addresses of other agency representatives to be included in the response. Use semicolons to separate multiple email addresses.

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Type your question:(required)