Flood Waiver

Flood Insurance Waiver
WHY YOU SHOULD HAVE FLOOD INSURANCE PROTECTION
•Everyone lives in a flood zone- it is just a question of whether you live in a low, moderate, or high risk area.
•Nearly 25% of all flood claims are for properties located in lower-risk flood areas or those property locations where flooding is not expected.
•Changing weather patterns as well as residential and business development may increase your chances of experiencing a flood loss.
•Your homeowner’s or personal property policy does not include coverage for damage caused by flooding.

Name *

First

Last

Phone Number *

###

####

Email *

Please use the email you would want us to get information back to you with.

Homeowners or Personal Property Policy Number

Enter EITHER home/personal property policy number OR address

Property Address

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

ELECTION TO NOT PURCHASE FLOOD INSURANCE

Decline all flood insurance through the National Flood Insurance Program.

Decline Building Coverage provided through the National Flood Insurance Program.

Decline Contents Coverage provided through the National Flood Insurance Program.

Decline all flood insurance (enter info below)

I understand that loss resulting from flood damage is not covered under my homeowner's or personal property policy, and that flood coverage is available through the National Flood Insurance Program (NFIP).
By signing this form, I am voluntarily choosing not to purchase flood protection for my building and/or contents under a National Flood Insurance Program policy as indicated below:

Effective Date

YYYY

If you chose above "Decline all Flood Insurance" Enter here the date it was started.

Policy number

If you chose above "Decline all Flood Insurance" Enter your current policy number.

ELECTION TO NOT PURCHASE EXCESS FLOOD INSURANCE

Decline all excess flood coverage.

Decline Excess Building Coverage.

Decline Excess Contents Coverage.

I understand that loss resulting from flood damage is not covered above the NFIP program limits for residential and non-residential buildings. Excess flood coverage is available to provide coverage above the NFIP limits.
By signing this form, I am voluntarily choosing not to purchase flood protection for my building and/or contents under an excess flood policy as indicated below:

Signature

Once you submit this form a copy will be emailed to you. Sign here and fax/email to 713-850-1621.

Date

YYYY

Authorization *

I Agree

By checking "I Agree" and submitting this form, you are declining flood insurance coverage. This will be need to be updated annually.

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713-396-5031

713-850-7622