Monitor information for the LTC Subscription:

Have your monitor fill out the forms needed for states you are requesting credit for and fax to: 619 421 8171

If you are requesting credit in the following states,
AL, CO, CT, DC, GA, HI, KS, MA, MI, MN, MS, MT, NC, NE, NJ, NV, OK, PA, RI, VT, VA, WV, WI, WY
you need to print and have your monitor fill out this monitor form: click here

If you are requesting credit in AR
you need to print and have your monitor fill out this monitor form: click here

If you are requesting credit in AZ
you need to print and have your monitor fill out this monitor form: click here

If you are requesting credit in IA
you need to print and have your monitor fill out this monitor form: click here

If you are requesting credit in IN
you need to print and have your monitor fill out this monitor form: click here

If you are requesting credit in MO
you need to print and have your monitor fill out this monitor form: click here

If you are requesting credit in SC
you need to print and have your monitor fill out this monitor form: click here

If you are requesting credit in WV
you need to print and have your monitor fill out this monitor form: click here