We enjoy serving you. Please fill out and submit the form below to reflect the changes you wish to incorporate in your policy. A represenative will be in contact with you shortley.

Manjoe Staff

Change Homeowners Policy Form
Fields marked with asterisks (**) are required.

In the following section, deductable refers to the amount you must pay before the policy coverage is in effect.

Building Coverage

Homeowners General Policy Changes

Homeowners Policy Information

Please fill out the Policy Number and Policy Name Information, then enter changes for the appropriate section(s) below. Note Policy Name refers to the persons name on the existing homeowner policy.

Changing a Homeowners Policy

Personal Property Scheduled Item

Recreational Items

You can insure specific items such as a Wedding ring for $5000, Antique Vase for $2000 or fur coat for $10000. Note: A recent apprasial may be required before coverage is effective.

Swimming Pool / Hot Tub

Alarm System

Value of the Recreational Item: $
Date Construction was Completed:
Make Item Value: $
Depth of Pool / Hot tub:
Item Description:
Length x Width of Pool / Hot tub:
** Policy Name:
** Effective Date:
** Change Zip Code To:
Change Street Name To:
** Policy Number:
Change Deductable To: $
Change Contact Phone Number To:
Change Loan Number To:
Increase Building Value To: $
Describe the use of additional space:
Change the Mortgagee on the Policy to:
Change the Name(s) on the Policy to:
Change the Billing Address To:
Describe the recreational item and its use:
** I Understand all changes in Coverage are subject to Underwriting approval by the Insurance Carrier who provides the coverage under your Homeowners Policy. Additional Information may be requested by the Underwriting Carrier before coverage can be considered to be effective.Coverage is not to be considered bound until all underwriting information requested by the Underwriting Carrier is received, accepted and approved.. Coverage is not to be considered bound until all premiums for the additional coverage is received, accepted and payments cleared.
Alarm Options:
Pool / Hot tub Security:
Recreational Options:
Schedule Item:
Building Coverage:
Pool / Hot Tub Options:
New Alarm Type:
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