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Abuse and Molestation Application
Abuse and Molestation Application
Step
1
of
2
50%
Abuse and Molestation Application
Are you required to carry SAM (sexual abuse and molestation) insurance by a contract?
(Required)
Yes
No
Do you have a copy of the contract?
(Required)
Yes
No
Upload the copy of the contract
(Required)
Max. file size: 128 MB.
Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Instructions
Upon clicking the “CONTINUE” button below, you will be directed to a PDF web form with the corresponding SAM application. If you have any questions, feel free to call us at 877-239-0067, Option 1, and a friendly licensed insurance agent will be happy to assist you further.