Tattoo/PMU Artist Insurance Application

Tattoo/PMU Insurance Application
Name*

First NameLast Name
Business Name*
Entity Type

CorporationLLCSole ProprietorOther
Mailing Address*
Business Address (If Different)
Phone Number*

Area CodePhone Number
Email*
example@example.com
If you are required to add any entity on as Additional Insured on your Policy, please list the name & address below:
Year Business Started*
# of Losses in the past 5 yrs
Are you currently insured?
If Insured Provide Current Carrier & Exp Date
What Services Do You Provide*

Body PiercingTattooPermanent MakeupMicroblading OnlySalon ServicesOther
Do You Tattoo Minors*

YesNo
Do You Pierce Minors*

YesNo
Do You Sell Any Products*
If Yes Provide Estimated Annual Sales
Years of Experience*
Total Hours of Live Training Completed
This field pertains to PMU/Microblading services only
Where were you certified?
This field pertains to PMU/Microblading services only
Final Date Attended
This field pertains to PMU/Microblading services only
Looking to expedite the approval process? Upload your certificate of training and/or supporting certificates/licenses

Browse Files

Cancelof
Need Consent & Aftercare Forms? Check Out Our Library For Free Example Forms
Select Desired Coverage Below*

General & Professional LiabilityBusiness Personal PropertyExcess Liability CoverageHired & Non-Owned Auto Liability
Business Personal Property Limit

$5,000$10,000$20,000$20,000 + Please Note Below
Please note adding Business Personal Property, Excess Liability, and/or HNOA coverage adds 1-3 business days to the quote time.
Effective Date Needed By*

MonthDayYear
Additional Information We Should Know
Thank you for your application, an agent will be contact with you shortly to address any questions and provide the requested quote. Should you wish to speak with an agent immediately about this application please contact us directly at:

P: (602) 888-1732

E: info@cityscapeinsurance.com

IT IS UNDERSTOOD AND AGREED THAT THE COMPLETION OF THIS APPLICATION SHALL NOT BE BINDING EITHER TO THE PROPOSED INSURED OR TO THE COMPANY UNTIL ACCEPTED BY THE COMPANY OR COMPANIES IN WRITING.
Please verify that you are human*
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Tattoo/PMU Insurance Application