2023 Dues Premium Request

Pursuant to the Board’s request, please complete this premium request and return to this office so that dues for 2023 can be established and billing completed.

If you have more than one company that writes premium in Wisconsin you will need to complete this form for each company.  If you have any questions please contact Karla at kkahl@wisinsalliance.com or by telephone at 608-255-1749 or 608-220-2750.

Thank you.

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Wisconsin Insurance Alliance