Add MIB Website to Forms – Effective 12/07/20

Effective December 7, 2020, the MIB website will be added to the Important Notice About Your Application for Insurance form (ORD 96200B 2020) as its primary point of contact.

Revised Important Notice About Your Application for Insurance:
The Important Notice About Your Application for Insurance form (ORD 96200B 2020) has been revised as follows:

• MIB’s website has been added in place of their physical address under Disclosing Information
• The generic and all state specific forms are impacted by this change.
• The form carries a revision date of 2020.

The revised forms are required with applications taken with a Part 1 date of December 7, 2020, and later. The previous form will continue to be accepted until December 27, 2020.

The new forms will be available on the PruXpress website Monday, December 7, 2020.