DWELLING POLICY PROGRAM FORMS – IA, MN, …

1 <<<<< DWELLING POLICY PROGRAM FORMS IA, MN, NE, ND, OK, SD, WI >>>>> form NUMBERS & EDITION DATES COMP. TITLE PAGE 1 OF 2 PROPERTY FORMS COMPUTER GENERATED AUTOMATIC INCREASE IN INSURANCE COMPUTER GENERATED DWELLING FIRE DECLARATIONS COMPUTER GENERATED FIRE DEPARTMENT SERVICE CHARGE (Coverage wording included in DF-1, DF-2 and DF-3) COMPUTER GENERATED TENANT S IMPROVEMENTS (only available on DF-1 & DF-2) DF-1 1-04 NSM DWELLING PROPERTY BASIC form DF-2 1-04 NSM DWELLING PROPERTY - BROAD form DF-3 1-04 NSM DWELLING PROPERTY - SPECIAL form DF-12 8-12 NSM EARTHQUAKE DF-14 1-04 NSM INSURANCE BY MORE THAN ONE COMPANY DF-15 1-04 NSM COVERAGE C HIGHER LIMITS ON CERTAIN PROPERTY DF-16 1-04 NSM INCIDENTAL BUSINESS ACTIVITIES RELATED PRIVATE STRUCTURES NS-25 9-98 NSM CONSENT TO MOVE MOBILE HOME NS-26 9-98 NSM COLLISION OR OVERTURN OF MOBILE HOME DF-27 1-04 NSM SECURED PARTY S INTEREST ADDITIONAL COVERAGE DF-28 1-04 NSM SECURED PARTY S INTEREST ADDITIONAL

2 COVERAGE DF-32 8-07 NSM CONDOMINIUM UNIT-OWNER ADDITIONS DF-33 3-05 NSM CONDOMINIUM UNIT-OWNER ADDITIONS SPECIAL COVERAGE DF-34 1-04 NSM BROAD THEFT COVERAGE DF-35 1-04 NSM LIMITED THEFT COVERAGE DF-36 1-04 NSM CREDIT CARD, FORGERY AND COUNTERFEIT MONEY DF-41 1-04 NSM ADDITIONAL INTERESTS ML-48 AAIS RELATED PRIVATE STRUCTURES DF-50 8-07 NSM RESIDENTIAL ASSOCIATION LOSS ASSESSMENT DF-53 8-07 NSM RESIDENTIAL ASSOCIATION EARTHQUAKE LOSS ASSESSMENT DF-55 1-04 NSM REPLACEMENT VALUE LOSS SETTLEMENT TERMS (IA,NE,ND,OK,SD,WI) DF-55M 1-04 NSM REPLACEMENT VALUE LOSS SETTLEMENT TERMS (MN) DF-85 01-18 NSM AMENDATORY ENDORSEMENT WISCONSIN (WI) ML-101 12-79 AAIS REQUIRED FIRE form (IA) DF-122 1-17 NSM AMENDATORY ENDORSEMENT MINNESOTA (MN) DF-126 1-17 NSM AMENDATORY ENDORSEMENT NEBRASKA (NE) DF-133 1-17 NSM AMENDATORY ENDORSEMENT NORTH DAKOTA (ND) DF-135 1-17 NSM AMENDATORY ENDORSEMENT OKLAHOMA (OK) DF-140 1-17 NSM AMENDATORY ENDORSEMENT SOUTH DAKOTA (SD) DF-141 1-04 NSM ADDITIONAL INSURED (To be used only when the NS-700 or the NS-710 is attached)

3 DF-200 1-04 NSM REPLACEMENT COST COVERAGE (MOBILE HOMES) (IA,MN,NE,ND,SD,WI) DF-208 1-04 NSM BACK UP OF SEWER, DRAIN OR SUMP SYSTEM (THIS IS NOT FLOOD INSURANCE) (IA,MN,ND,OK,SD,WI) DF-208N 1-04 NSM BACK UP OF SEWER, DRAIN OR SUMP SYSTEM (THIS IS NOT FLOOD INSURANCE) (NE) ML-216 AAIS PROTECTIVE DEVICES NS-248 1-02 NSM SCHEDULED RELATED PRIVATE STRUCTURES DF-257 1-04 NSM ORDINANCE OR LAW DF-304 1-04 NSM RESTRICTION OF INDIVIDUAL POLICIES (IA,MN,NE,ND) NS-413 7-15 NSM DWELLING UNDER CONSTRUCTION THEFT COV. DF-0453 1-17 NSM AMENDATORY ENDORSEMENT IOWA (IA) CF-624 10-05 NSM SOLID FUEL QUESTIONNAIRE CF-778 11-12 NSM DWELLING POLICY JACKET CF-842 7-15 NSM CONTRACT EXPLANATION (To be used only when liability is added) DF-987 1-04 NSM ADDITIONAL INSURED (To be used only when the NS-800 is attached) DF-1185 1-04 NSM REFRIGERATED FOOD SPOILAGE <<<<< DWELLING POLICY PROGRAM FORMS IA, MN, NE, ND, OK, SD >>>>> form NUMBERS & EDITION DATES COMP.

4 TITLE PAGE 2 OF 2 NSCF-1243 08-11 NSM NOTICE CONCERNING POLICYHOLDER RIGHTS IN AN INSOLVENCY UNDER THE MINNESOTA INSURANCE guaranty ASSOCIATION LAW (MN) (This notice must be given with the application. The notice must be given in writing or in the same medium as the application for insurance. This notice would only be attached to renewal certificates if the renewal increases the dollar amount of a coverage by more than 100%.) (The NSCF-1243 will not show on the dec.!) CF-1266 8-08 NSM DWELLING FIRE APPLICATION (OK) CF-1366 10-93 NSM OKLAHOMA NOTICE (OK) DF-1375 1-04 NSM DWELLING UNDER CONSTRUCTION DF-1467 1-04 NSM REPLACEMENT COST COVERAGE (BUILDINGS) (IA,MN,NE,ND,SD,WI) CF-1480 02-18 NSM DWELLING FIRE APPLICATION (IA,MN,NE,ND,SD,WI) CF-1572 4-98 NSM CALENDAR DATE OR TIME FAILURE EXCLUSION CF-1736 1-15 NSM CERTIFIED TERRORISM LOSS COVERAGE; NON-CERTIFIED TERRORISM LOSS EXCLUSION; NUCLEAR, BIOLOGICAL, CHEMICAL AND RADIOLOGICAL EXCLUSION.

5 WAR AND MILITARY ACTION EXCLUSION (RENTAL DWELLINGS ONLY) (MN, NE, ND, SD) DF-1781 1-04 NSM WINDSTORM OR HAIL OUTDOOR TELEVISION ANTENNAS CF-1782 1-04 NSM NOTICE TO POLICYHOLDERS (Various reductions of coverage) (MN,NE,ND,SD) DF-1786 1-15 NSM REPLACEMENT COST COVERAGE (BUILDINGS, EXCEPT ROOFS) DF-1787 1-04 NSM REPLACEMENT COST COVERAGE (MOBILE HOMES, EXCEPT ROOFS) (OK) CF-1788 2-04 NSM NOTICE TO POLICYHOLDERS DWELLING FIRE OKLAHOMA (Various reductions of coverage) (OK) CF-1848 8-08 NSM OKLAHOMA RURAL FIRE PROTECTION SUPPLEMENT (OK) CF-1895 1-15 NSM NOTICE OF TERRORISM INSURANCE (RENTAL DWELLINGS ONLY) (MN, NE, ND, SD) CF-1897 01-15 NSM CERTIFIED TERRORISM LOSS COVERAGE; NON-CERTIFIED TERRORISM LOSS EXCLUSION (WITH LIMITED EXCEPTION); NUCLEAR, BIOLOGICAL, CHEMICAL AND RADIOLOGICAL EXCLUSION.

6 WAR AND MILITARY ACTION EXCLUSION (RENTAL DWELLINGS ONLY) (IA, WI) CF-1898 1-15 NSM NOTICE OF TERRORISM INSURANCE (RENTAL DWELLINGS ONLY) (IA, WI) CF-2045 01-13 NSM NOTICE TO POLICYHOLDERS (EARTHQUAKE COVERAGE DEDUCTIBLE CHANGE) CF-2050 1-13 NSM WINDSTORM OR HAIL DEDUCTIBLE DF-2119 1-16 NSM Exclusion Of Loss Due To By-Products From Production Or Processing Products LIABILITY FORMS For Liability FORMS that can be added to the DWELLING Fire POLICY , see the Farm Personal Liability/Personal Liability FORMS listing.