New or Renewal Liability Clients

Please complete the state-specific application below. These forms are for new or renewal clients. If you are NOT a member of an HBPA affiliate, please include a separate check for $200 the annual associate membership fee made payable to the National HBPA. If you are paying the premium online, please mail a $200 check made payable to the National HBPA, 3380 Paris Pike Lexington KY 40511. If you have a question about your membership please call the National HBPA at 859-259-0451 or visit the National HBPA website for additional information. To view the National HBPA state affiliate directory, click here.

Connecticut Residents:

Florida Residents:

Kansas Residents:

Kentucky Residents:

Missouri Residents:

New Jersey Residents:

New York Residents:

Washington Residents:

All Other States:

Excess Liability