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  1. Local Government Insurance Trust
    7225 Parkway Dr.
    Hanover, MD 21076

    If you have a question or concern you would like the Trust to address, please submit this form. Please DO NOT request a Certificate of Insurance via Contact Us. Request a COI on the Member Portal or contact your underwriter. DO NOT submit this form to contact CLAIMS. They do not receive this report. We will try to address your request in a timely manner.

  2. Contact Information

  3. Departments
  4. Which department would you like to contact?*

  5. Questions & Concerns

  6. Would you like to be contacted concerning your request?*

  7. Leave This Blank:

  8. This field is not part of the form submission.