Insurance and Corporate Clients

We appreciate your interest in our Web Site and the legal services we provide our clients. To assist us in evaluating any legal issues you feel require representation please complete and submit this form or print it out and fax it to Frank A. Composto at (718) 855-6866:

Please provide the following contact information:

Name of Insurance Company or Corporation 

Address

Address (cont.)

City

State

Zip Code

Insurance Company Code

Local Contact Person or Claims Manager

Telephone (Home Office)

Telephone (Local)

What is the best time and way to contact you?


Briefly, describe the event or situation you feel requires our services:.


Copyright © 2004 Composto & Composto. All rights reserved.
Revised: 06/09/03