Find Flood Insurance

First Name:

 

 

Middle Initial:

  Select One A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

 

Last Name:

 

 

Social Security Number:

 

 

Mailing Address:

 

 

City:

 

 

State:

  Select One NJ PA

 

Zip Code:

 

 

Email Address:

 

 

Home Phone:

 

 

Work Phone:

 

 

Extension:

 

 

How to Contact You:

  Select One Phone at Work Phone at Home Email

 

Flood Zone:

 

 

County:

 

 

 

Building Information

Building Occupancy:

  Select One Single Occupancy 2 to 4 Family Other Residential Non-Residential

 

Are you applying for this flood insurance policy on behalf of the lender for the Mortgage Portfolio Protection Program?

  Select One Yes No

 

Condo Association and Residential Building?

  Select One Yes No

 

Has property incurred 2 or more losses?

  Select One Yes No

 

Is property granfathered into a B, C or X Zone?

  Select One Yes No

 

Select Policy Type:

  Select One Regular Preferred

 

 

Coverage Information

Replacement Cost ($):

 

 

Total Building Coverage ($):

 

 

Total Content Coverage ($):

 

 

Building Type:

  Select One 1 Floor Split-Level 2 Floors 3 or more Floors Townhouse/Rowhouse Manufactured Home

 

Construction Date (mm/dd/yyyy):

 

 

Number of units in building:

  Select One 0 1 2 3 4 5 or more

 

Condo Association:

  Select One Yes No

 

 

Basement/Enclosure Information

Basement/Enclosure or Crawl Space:

  Select One None Basement Enclosure or Crawl Space

 

Does enclosure or crawl space area have compliant venting:

  Select One Yes No

 

Finished Area:

  Select One Yes No

 

Machinery/Equipment:

  Select One Yes No

 

Building Elevated:

  Select One Yes No

 

Lowest floor which includes living area, is off the ground by means of:

  Select One Piles Posts Piers Columns Solid Perimeter Walls Parallel Walls Other

 

Area used for:

  Select One Parking Storage Access Other

 

Square foot area:

 

 

Enclosure Walls:

  Select One Breakaway Solid Perimeter Lattice Other

 

 

Contents Location

Contents Location:

  Select One Lowest Floor Only – Above Ground Level Lowest Floor Above Ground Level and Higher Floors Above Ground Level by 1 Floor or More

 

 

Miscellaneous Information

Is the building flood proofed:

  Select One Yes No

 

Wave height adjustment:

  Select One Yes No

 

Flood Insurance Questions:

 

 

 

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