Policyholder Information Request Form

Thank you for contacting the Privacy Coordinator at EMC Insurance Companies. Please complete all fields applicable to your request and click Send Request.

California Consumer Privacy Act Forms

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Name*: Address: City: State: ZIP Code: Phone Number: Email:* Policy Number (last 4 digits): Any Relevant Claim Numbers:

Type of Information Requested: *

Removal of information
Personal information inquiry
Other*
Additional information:

EMC Insurance Companies

Privacy Coordinator
P.O. Box 712
Des Moines, IA 50306-0712

Policyholder Information Request Form

California Consumer Privacy Act Forms

EMC Insurance Companies

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