Acord 84 Form – Fillable Dwelling Fire Application
Fillable 84 Acord Form
An Acord 84 form is a legitimate document required in the insurance industry to gather property information and assess the level of coverage needed. It is commonly known as a “Dwelling Fire Application.” This application helps cover a dwelling fire insurance policy for homes that are not eligible for standard homeowners insurance policies.
This form also allows insurers uniform coverage and streamlines the process for all involved parties. You can obtain the current application by clicking the download button quickly.

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Why is the ACORD 84 Fillable Form Important?
It provides protection against windstorms, vandalism, and fire lightning. However, it simplifies the application process and is more critical in the following scenarios:
Standardization
This form helps assess the risk and determine coverage due to its consistent format. It ensures that all relevant information is filled in to reduce errors.
Legal Documentation
This form protects the insurers and the policyholders from legal complications by verifying the information the applicant provides.
Enhanced Communication
This consistent format improves communication between agents, insurers, and brokers to ensure the quick application process.
Premium Calculations
Accurate information about the property and applicant helps analyze risk factors and calculate premiums to mitigate financial loss.
How To Obtain a Fillable ACORD 84 Dwelling Fire Insurance Policy Application Form
Contact Insurance Agent
You must contact your insurance agent and request to arrange a meeting. Collect all accurate related information and provide it to the agent. He/she will verify and help complete this application. Later, recheck the info mentioned in all fields and submit it to the authorized representative.
Official Website
It is also essential to visit the homepage of Acord’s official website. It offers various current forms to fulfil users’ intent. Moreover, type the form’s name in the search bar and click the download button to save it on your computer or mobile.
Third-Party Website
You can also visit any third-party website offering insurance forms, such as Forms Dude. You must type www.formsdude.com in any web browser and visit its homepage. Then, click the “Insurance Forms” category on the top menu bar. Write the current form’s name (Acord 84 Form) in the search bar. Click the download button to save instantaneously on your device.
Step-by-Step Instructions for Filling Out the Blank Acord 84 Form
Ensure the given step-by-step instructions for accurately filling out this form:
1- Agency Information
You must write the contact person’s full name, phone number, fax number, email address, code, subcode, and customer ID number.
2- Insured Information
Write the insured’s full name, NAIC (National Association of Insurance Commissioners) number, policy number, plan, facility code, effective date, expiration date, last inspection date, and duration.
3- Applicant Information
In this section, write the applicant’s full name (first, middle, and last), date of birth, social security number, marital status, and contact number. Also, write the current and previous address, occupation, mailing address, email address, experience, and dwelling location.
4- Coverages/Limits of Liability
In this section, mention the type of coverage, its amount, and premium. Also, write the deductible amounts.
5- Forms & Endorsement
You must write the location number, form number, form name, addition date, and copyright owner’s code. Note: If more space is required for the endorsement schedule, attach Acord 829.
6- Payment Plan
This section describes the billing account number, deposit amount, and estimated total premium amount. Also, check the billing, payment plan, payment method, and mail sent section.
7- Rating/Underwriting
In this section, write the detailed information about the construction of the building. It includes construction type, course, housekeeping condition, protection, occupancy, plumbing condition, residence type, roof details, and other related information.
8- Optional Coverage
In this section, write the type of coverage, coverage information, premium amount, and deductible amount.
9- General Information
In this section, explain all the responses in “Yes” or “No.”
10- General Information – Residence
In this section, also explain all the responses in “Yes” or “No.”
11- Prior Coverage
Write the carrier’s name, policy number, and expiration date.
12- Loss History
Write the entry’s loss date, type, description, category number, amount paid, and agent or company name.
13- Additional Interest
In this section, choose the interest type and write the name and address of interest, evidence number, certificate number, receiver, and loan number.
14- Remarks
In this section, write policy remarks and clauses for better understanding. Moreover, attach Acord 45 if more space is required.
15- Signature
Lastly, write the producer’s name, state license number (Florida), and national producer number. Also, get the producer’s and applicant’s signatures with the date.
Additional Details to Consider While Filling Out Acord 84 Form
You must ensure the following additional details during the fill out of this form for smooth coverage:
Incomplete Information
You must avoid providing incomplete information to your agent, which causes delays in the application process.
Inaccurate Data
Providing inaccurate data leads to miscommunication, which causes inappropriate coverage for assessing risk and the claim process.
Updated Format
If the policy coverage changes, you must request that the insurance agent provide an updated format.
Additional Documents
It is crucial to provide accurate additional documents to attach with the primary form recommended by your insurance agent.
FAQS
What is the Acord 84 Form?
This form is valid in the insurance industry for requesting dwelling fire insurance coverage for specific residential properties. It provides detailed information to help you understand the application and increases the chances of its process.
What Information Does the Acord 84 Require?
It requires applicant information, coverages, payment plans, underwriting, general information, additional interest, and loss history.
What is a Dwelling Fire Insurance Policy?
This policy covers the physical damage to personal property and liability, which is not eligible for standard homeowners insurance to reduce the financial loss.
Is the Acord 84 Application Mandatory for Dwelling Fire Insurance?
Some insurance companies ask for this application form to streamline the process effectively.