Once you've completed your forms, please attach:
- A copy of your 1040 tax form
- Proof that you're self-employed and living and working in downstate New York. Acceptable documentation includes a Schedule C, NYS-45, Certificate of Incorporate, K-1, or Business Certificate. To learn more on how to obtain a Business Certificate, click here. Confused? Contact Jason Silverman or Bryan Kelly (below).
- A check for your first month's premium
- Only if you are not already an AvantGuild member: a $59 check to "Mediabistro.com, Inc." to cover the annual AvantGuild membership fee.

Here's the address:
IRBA/mediabistro.com
Attn: Jason Silverman & Bryan Kelly
490 East 74th Street, Suite 5A
New York, NY 10021
Please note: Applications must be received at least 10 days prior to the effective date of the policy. All policies are effective on the first of the month.
| Unsure how to document your self-employment? Other insurance questions? Contact Jason Silverman or Bryan Kelly at or (212) 879-0122. |