How to Request a Change
- Click here to open the Policy Service Request Form. You will need the free Adobe Acrobat Reader to view and print it.
- Fill out the shaded part and the section appropriate to your change. The form can be filled out electronically or by hand.
- Print the form. Please make sure you've signed it and fax it to 608.257.3940.
The form may also be mailed to NGL, PMB 749, 123 Town Square Place, Jersey City, NJ 07310. If you have any questions or problems, please feel free to call us at
You will receive confirmation of your policy change by mail.
Completing the Form Electronically
Check the boxes of your choice by placing the mouse over the box and
clicking (the cursor will turn from a hand to an arrow). To un-check a
box, simply click on it a second time.
- To type on a line, click where you want to start and begin typing. Use the tab key to advance to the next line.
Once you've completed all applicable fields, print the form by clicking
on the print button at the top of the screen (part of Acrobat Reader).
When you close the Acrobat Reader, your entries will not be saved. If
you print the form and realize you need to add or change something, your
entries will still exist as long as you did not close the program.