Change of Insurance Notice

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Our staff is available by phone Monday - Friday, from 8 a.m. to 6 p.m.
Call (800) 241-1151 or Call direct at (617) 956-9999
We will be happy to answer any of your questions.

If you need a change to your insurance policy, you are welcome to complete the form below. A confirmation will be sent to you to confirm changes. If you do not hear from us, please call.

Filling out this form does not change or bind your coverage. Telephone numbers must be completed.

State Fund Insurance Agency Inc.
Change Request Form

Name
Daytime Phone
Other Phone (cell)
What insurance policy needs a change? Check all that apply	Auto Insurance Home Owners Renters Condo Life Liability InsuranceLong Term Care Business / Commercial Jewelry / Arts Workman Compensation Other
Address on the insurance policy
If change of address - please enter your New Address
E-mail
If change of email, please enter
Phone
If change of phone - please enter here
Effective date requested
Current insurance company
policy number (if known)
If you need to add coverage's to your existing policy, please describe the items and values
Other Changes
Other comments

State Fund Insurance Agency Inc. Change Request Form

State Fund Insurance Agency Inc.
Change Request Form