Cyber Liability Coverage Application If you would like to add Cyber Coverage to your existing 2017 Policy, please complete the following application and remit payment by credit card. Please contact us at (800)-843-2277 with any additional questions. Scroll Down For current 2017 LPL Policyholders only. All 2018 Policies include this coverage*. Click here for more information Firm Name*Current LPL Policy Number:*Number of Attorneys*Please enter a number from 1 to 30.Cyber Liability Coverage* Price: $26.50 * Price is per AttorneyTotal $0.00 Insured Designee*Billing InformationCredit Card Total $0.00 Name* First Last Email* Enter Email Confirm Email Credit Card Billing Address* Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name CAPTCHACommentsThis field is for validation purposes and should be left unchanged. *Limits are $50,000 per claim; $50,000 aggregate for firms of up to 10 attorneys and $150,000 aggregate for larger firms.