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General Liability Request Form
This insurance is available only to State and Local Associations.
Individuals are not able to receive coverage for recitals or other events.
General Liability (1 of 4)
Name of State or Local Association
Name of Event
Date(s) of Event
Date Certificate is Needed (please allow two weeks for processing)
Additional Information About Event
MTNA National Headquarters
1 W. 4th St., Ste. 1550 Cincinnati, OH 45202
Phone: (513) 421-1420 or (888) 512-5278
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