Borrower Description

Collateral Description

Field Name	Current System Information	New Collateral Information

Updates do not affect current coverage.

Borrower Information

Borrower Name*

Mailing Address*

Collateral Information

Collateral Address*

Collateral Year*

Make*

Model

VIN*

Flood Zone*

Coverage Amount*

Property Type*

Borrower Information

Balance

Collateral Description	Flood Zone

Item	Ins company	Policy	Status	Effective Date	Expiration Date	Property Type	Stage	Notice Date	Prem Due

Renewal Details

		Borrower Information	Collateral Description	Property Type	Coverage Amount	Flood Zone	Notes	Action By	Action On

Agent

Call Agent

Fax Agent

E-mail Agent

Payee

Payee Address

Comments

Notes	Created By	Date

Reason to Cancel Policy*

Cancel Date *

Documents (drop jpg or png or jpeg or pdf documents here)

Status

Insurance Provided Information

Carrier Name *

Policy Number *

Effective Date *

Expiration Date *

Borrower Information

Balance

Collateral Code *

Collateral Code Description

Property Type *

Collateral Year *

Make *

VIN *

Model

Apply %

CPP Value

Flood Zone

Flood Value

Hazard Value

Address *

Collateral Notes

Notes	Created By	Date

Documents (drop documents here)

Borrower Information

Coverage Amount

Property Type

Collateral Description	Flood Zone

Item	Ins company	Policy	Status	Cancelled Date	Coverage Amount	Effective Date	Expiration Date	Property Type	Stage	Notice Date	Prem Due

Renewal Details ( Click on an item to view details or make updates.)

		Borrower Information	Collateral Description	Property Type	Coverage Amount	Flood Zone	Notes	Action By	Action On

Agent

Call Agent

Fax Agent

E-mail Agent

Payee

Payee Address

Collateral Notes

Notes	Created By	Date

Insurance Notes

Notes	Created By	Date

Reason to Stop Cycle

Cancel Date *

Certificate

Type

Returned Total Premium

Comments

Notes	Created By	Date

Documents (drop png or jpeg or pdf or word documents here)

Insurance Provided Information

Carrier Name *

Policy Number *

Effective Date *

Expiration Date *

Coverage Amount *

Yes

No

Insurance Amount Required: *

If YES - system will mark coverage as acceptable. This will not be questioned at renewal as long as the amount has not decreased.
If NO - system will start a deficiency cycle to request the required amount of coverage. Please provide the required coverage amount – coverage amount can not exceed the value of the building, land cannot be insured.

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