HOW TO APPLY
A separate application is needed for each location. Location is defined as any separate building or structure rated separately by the Insurance Service Office.
Application Form PFP-3/ACORD 64 Pa must be used for Property Insurance coverage. Supplementary Questionaire PDWV-25 ACORD 65 PA/DE/WV is also required for fully or partially vacant or unoccupied buildings. Address Location Questionnaire PDFP-86 is required if a specific street name and house number are not assigned to the premises. See How to Apply in General Rules and Procedures for more specifics.
Separate Applications are required for Crime Coverage. See Pennsylvania Crime Insurance Program in General Rules and Procedures for more information.
To complete an Electronic Application, click here.
Printable and Viewable Application Forms
FOR PROPERTY INSURANCE POLICIES
FOR CRIME INSURANCE POLICIES