NYPIUA E-Delivery Service

SUBMIT E-MAIL ADDRESS

To take full advantage of the services provided by the NYPIUA E-Delivery Service, complete this form to be added to our e-mail directory.

Contact Name:

Company Name:

Contact Address:

E-Mail Address:
Confirm E-Mail Address:
Telephone Number: - -
NYPIUA ID (if known):




Consent to Electronic Delivery

To allow you to receive your copy of the clients’ policy documents and other communications from New York Property Insurance Underwriting Association faster and more efficiently, NYPIUA is now offering electronic delivery of documents. If you so consent, by completing this form, documents previously mailed to you will be delivered electronically for you to read, store and/or print as you choose. Documents will be retained at NYPIUA and will be available to you in paper form at any time upon your request. You may also, at any time, revoke your consent for electronic delivery.

By agreeing below to accept electronic delivery you agree to receive by electronic delivery any documents relating to your business with NYPIUA. NYPIUA reserves its right to provide you with paper, if necessary (instead of electronic versions), which will be mailed to the address we have on file for you.

You may withdraw your consent at any time by notifying us in writing. Your written withdrawal request can be submitted through our website, www.nypiua.com, by e-mail at fairplan@nypiua.com, or by mail. Please mail to NYPIUA, 100 William St. 11th Fl, New York, NY 10038.

By accepting electronic delivery below, you also agree that you have the necessary equipment (computer and printer) as well as internet connection to communicate with NYPIUA and that you have a valid e-mail address which you will maintain as long as you do business with NYPIUA. If your e-mail changes, you agree to notify us in writing on our webpage, www.nypiua.com, by e-mail at fairplan@nypiua.com, or by mail.

Remember, if you sign up for electronic delivery, you may at any time request a printed version of any document we had previously e-mailed or sent to you. We will continue to mail documents to policyholders under present procedures.

I agree to electronic delivery. Discontinue mailing paper documents.

I disagree to the above terms. Continue to send paper documents.