Business Info Request Retirement Planning

Gorman Insurance and Risk
Management Services of
Somersworth, NH offers
affordable Commercial
Insurance coverage options
and experienced business
insurance services
throughout New
Hampshire, southern
Maine, and Massachusetts.

Contact us about Group
Health Insurance toll free at
1-800-678-3431, as well as
Group Life and Group
Long Term Care Insurance
services for your NH, ME,
or MA business.

We are your local southeastern New Hampshire, southern Maine
insurance agency, offering experienced group long term care insurance
services to businesses located in the following cities and counties:
Somersworth, Durham, Portsmouth, Dover, Rochester, Rollinsford,
Barrington, Madbury, Lee, Strafford, Farmington, Milton, Barnstead,
Nottingham, Northwood, Raymond, Newmarket, Newfields, Stratham, Rye,
Hampton, Epping, Exeter, Salem, Danville, Deerfield, West Rye, Derry,
Chichester, South Barnstead, Gilmanton, New Durham, Wolfeboro, Alton,
Laconia, Berlin, Lebanon, East Candia, North Hampton, Hanover, Littleton,
Plymouth, Claremont, Newport, Keene, Hampton, Rye Beach, Strafford
County, Rockingham County, Hillsborough County, Merrimack County,
and Belknap County, NH. We also offer group long term care insurance
services throughout the state of New Hampshire, including the
Manchester, Nashua, and Concord area. Our service area in southern
Maine includes the following cities and counties: South Lebanon, Kittery,
Eliot, Berwick, Sanford, Blaisdell Corners, Springvale, Emery Mills, Wells
Beach, York Beach, Kittery Point, Kennebunk, Saco, Biddeford, Alfred,
Portland, Scarborough, Westbrook, Waterboro, Shapleigh, Newfield,
Buxton, Goodwins Mills, South Sanford, Cape Elizabeth, South Portland,
York County, and Cumberland County, ME.

New Hampshire Business Information:

Business Name:
Premises Address:
City:
State: (New Hampshire, Maine or Massachusetts)
Zip Code:
Contact Name:
Phone #:    Ext #:
Fax:    Years in Business:
Email Address: (Required)
Description of Operations or SIC code:

Current Insurance Company:
Policy Expiration Date:          (mm/dd/yyyy)

Do you currently offer Retirement Plans to employees?
Want Retirement Plans For:
Want Business Retirement Plans Information On:

How many employees to be offered benefits:

Additional Question or Comment:

Click on the "Submit Information" button below to send
your New Hampshire Business Retirement Planning request.**

**Information received from this Business Retirement Plans request form sent to Gorman Insurance and Risk Management Services, will be for our use only and will not be sold, given to or distributed to any other parties. By submitting this request you acknowledge that this is neither an offer to insure nor a guarantee of insurance. Completion of this form does not entitle or give approval to your business for retirement planning services. We are licensed in New Hampshire, Maine, Massachusetts, and will not provide quotes for other states.