Transcription of ACORD FLOOD INSURANCE APPLICATION
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ACORD FLOOD INSURANCE APPLICATION
FLOOD INSURANCE APPLICATIONCONSTRUCTION AND COMMUNITY INFORMATIONCOVERAGE AND RATING (One building per policy - blanket coverage not permitted)PLEASE ATTACH TO NFIP COPY OF APP CHECK OR MONEY ORDER FOR THE TOTAL PREPAID AMOUNTACORD 301 (3/97)acOACORD CORPORATION 1996 PRODUCERPHONE(A/C, No, Ext):POLICY TYPEINSURANCE COMPANY NAMESTANDARD POLICYRCBAPSCHEDULED BUILDINGMPPPCURRENT POLICY #FLNEWRNWL1 YR3 YRSAGENT STAX IDSOCIAL SECURITY #INSURED S NAME, PHONE #AND MAILING ADDRESSSOC SEC #:IS INSURANCE REQUIRED FOR DISASTER ASSISTANCE?YESNOIF YES:1. SBA2. FEMA3. FMHA4. OTHER (SPECIFY):CASE NUMBER OR SOCIAL SECURITY #:DIRECT BILL TOINSUREDFIRST MORTGAGEESECOND MTGEELOSS PAYEEOTHERWAITING PERIOD:STANDARD 30-DAYINITIAL PURCHASE OF FLOOD INS RELATED TO:LOAN-NO WAITINGMAP REV (ZONE CHANGE FROMNON-SFHA TO SFHA)-- ONE DAYPOLICY EFF DATEPOLICY EXP DATE12:01 LOCAL TIMEAT THE INSURED PROPERTY LOCATIONPROPERTY LOCATIONIS INSURED PROPERTY LOCATION SAME AS INSURED MAILING ADDRESS?
FLOOD INSURANCE APPLICATION CONSTRUCTION AND COMMUNITY INFORMATION COVERAGE AND RATING (One building per policy - blanket coverage not permitted)
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