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SELF PAY 26-2195 ONLINE ENROLLMENT

Monthly Payment Plan

By submitting this application I confirm that I am legally residing in the United States and agree to the below Authorization of Payment, the membership fees selected below, and the terms of the selected membership plan.​

Please select your plan(s): Required
Available supplements with Legal Plan purchase:
I authorize my employer to deduct premiums from my earnings and remit to LegalShield

By submitting this form, I acknowledge that the LegalShield Legal Plan and ID Shield employee benefits were made available and explained to me completely. I have seen the brochure/factsheet and/or video listing specific benefit and benefit limitations of these plans. I authorize my employer to deduct premiums from my earnings and remit to LegalShield.

Thanks for submitting!

Self Pay Option 12-1895: Price Quote
Self Pay Option 12-1895: Text
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