Home Equity And Homeowner Loan Application Page 3
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1
2
3Member Request
To Provide Homeowners Policy
Homeowners Insurance Company
Name of Insurance Agent
Insurance Company Address
City
State
Zip
Homeowner’s Policy Number
RE:
Dear Agent:
Please accept my permission to provide a copy of the homeowners policy listed above
outlining all corresponding coverage, limits and deductibles to:
UNITED STATES SENATE
FEDERAL CREDIT UNION
Loan Services
P.O. Box 77920
Washington, DC 20013-8920
Additionally, please provide a written endorsement naming the UNITED STATES
SENATE FEDERAL CREDIT UNION as _____ First _____ Second ____ Third mortgagor.
Notify the Credit Union of any cancellation. Thank you.
X
X
Name(s) – please print
Address
City
State
Zip
ConmarSystems, Inc., Peachtree City, GA - EFORM 52595-B
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