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Affidavit of insurance coverage

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The document is an Affidavit of Insurance Coverage filed by the Plaintiff in a divorce case in the Superior Court of New Jersey. It outlines the insurance coverage details of both parties, including life, health, automobile, and homeowner's insurance. The affidavit requires disclosure of all known policies, their terms, beneficiaries, and any recent cancellations or modifications. It emphasizes that all listed insurance must be maintained until further court orders.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name, address, and phone number as the Plaintiff at the top of the form.
In the section for insurance coverage, list all known insurance policies. Start with 'Name of Insured' followed by 'Insurance Co. Name', 'Address', 'Phone', and 'Policy Number'.
For each policy, circle the type of insurance: Life, Health, Auto, Home, or Other. If applicable, include details about who else is covered under each policy.
If there have been any cancellations or modifications to these policies in the last ninety days, specify them in the designated area.
Finally, sign and date the affidavit at the bottom and ensure it is notarized.

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