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Easy Policy Assumption Request Form - Wright Flood

Policy Number:_____ Property Address:_____ _____Insured/Seller s Name:_____ Seller s Mailing Address if different than above:_____Seller s Phone number:_____ _____Requestor (Mortgage/Title) Company:_____ Address:_____Mortgage/Title Representative s Name: _____Representative s E-mail Address:_____Phone number:_____ Fax Number:_____Purchaser s Lender if different than above: _____ Address:_____Loan Number: _____Purchaser s Name: _____ Purchaser s Mailing Address:_____ Easy Policy Assumption Request Formrev (11/15)The named insured is selling or transferring ownership of property at the address below. The purchaser is requesting Assumption of the existing Flood insurance Policy upon closing in order to maintain continuous coverage.

listed above, including any right to reimbursement from the company of the unearned portion of premium paid to purchase the full-term policy. Any agreement to exchange monies as related to the transfer of the policy rights is between the buyer and seller only and will not include the input and/or participation of the company.

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