NJIUA FORMS

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The following is a list of current applications, questionnaires, and endorsement forms of the Association.

DWELLING BUSINESS

-New NJIUA Application Form ACORD 67(2010/05) and Instructions-

ACORD Form Application and Instructions

-Vacant/Unoccupied Property Supplemental Application VP 00 03 (2/00)-

Required with a new or renewal application for insurance on all vacant dwelling business. Also, required when a dwelling property goes vacant during the policy term.

-Supplementary Corporate Questionnaire NJ-1A (9/87)-

Required with any application when the named insured is a corporation, holding company, or other fictitious entity.

-Direct Authorization-

Required application when the Insured is not using an Agent or a Broker.

-Terrorism Risk Insurance Act New or Renewal Disclosure Notice ACORD 62 (012003)-

Provides offer for Certified Acts of Terrorism Coverage, discloses premium charge, and discloses existence of federal backstop. Customer must sign and return to reject coverage.

-Commercial Fire Application ACORD 68 NJ (2010/05)-

Used to request insurance for Commercial Fire Business for building and contents coverage.

-Commercial Underwriting Questionnaire NJ-1B (11/96)-

Required with any commercial application

-Supplementary Corporate Questionnaire NJ-1A (9/87)-

Required with any application when the named insured is a corporation, holding company, or other fictitious entity.

-Vacant/Unoccupied Property Supplemental Application VP 00 06 -

Required with a new or renewal application for insurance on all vacant commercial business. Also, required when a commercial property goes vacant during the policy term.

- CANCELLATION REQUEST / POLICY RELEASE ACORD 35(1/97)-

This form is used when an insured requests their policy be cancelled. It should be signed by the insured and the producer if applicable.

-Limited Fungi, Wet or Dry Rot, Or Bacteria Coverage DP0422 (04/02)-

Endorsement Form for Limited Fungi, Wet or Dry Rot, Or Bacteria Coverage

-Producer Endorsement NJ PE-77 (11/00)-

Used to correct the spelling of the named insured, mailing address of the named insured, and to add, delete, or change a mortgage on both dwelling and commercial policies.

-Policy Change Request NJ-3 (9/94)-

Used to request changes on both dwelling and commercial policies for changes not provided by the Producer Endorsement.

-Storekeepers Burglary and Robbery Policy NJC-50 (5/79)-

-Mercantile Open Stock Policy NJC-51 (5/79)-

-Mercantile Robbery and Safe Burglary Policy NJC-52 (5/79)-

-Office Burglary and Robbery Policy NJC-58 (3/91)-

-Residence Burglary and Robbery Policy NJC-59 (9/97)-