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Supplemental Application Information for MAIP …

Supplemental Application Information for maip PolicyholdersIMPORTANT: This is a writable PDF. Please complete it electronically. Follow these steps:1. Save a copy of this PDF to your computer with the file name of your choice ( , ); always keep the .pdf extension on the file name. 2. Open the newly named PDF using Adobe Acrobat and complete it by typing into the designated fields and/or selecting the appropriate radio buttons. Tip: You can tab from field to When finished, save your completed form (File/Save).4. Print and sign document.

Supplemental Application Information for MAIP Policyholders (continued) Additional Rating and Discount Information Please complete the items …

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