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Insurance claim declaration - Arizona Department of Housing

Insurance claim declaration - Arizona Department of Housing 2026

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The document is an insurance claim declaration where the signer certifies their previous financial assistance for their primary residence, confirms their residency, details an insurance payout received, and states that the funds will be used for repairs to the residence. It includes a certification under penalty of perjury.

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Begin by filling in your name at the top of the form, certifying your previous assistance from the Arizona Department of Housing. Ensure you provide accurate details regarding any financial assistance received.
In the 'Primary Residence' section, list the full address of your primary residence where you currently reside. This is crucial as it confirms your eligibility for assistance.
Next, indicate the amount received from your insurance claim and specify the name of the insurance company along with the date of payout.
Describe the situation that led to your insurance claim in detail. This helps clarify your circumstances and supports your request for funds.
Finally, outline how you plan to use the claim funds for repairs on your primary residence. Be specific about what repairs are needed.
Complete the certification section by signing, printing your name, providing an email address, and executing on today's date along with a phone number for contact purposes.

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2017	4.9 Satisfied (55 Votes)

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What is the Department of Insurance for any state responsible primarily for?

State insurance departments oversee producer activities in order to protect insurance consumer interests in insurance transactions. The states administer continuing education programs to ensure that agents meet high professional standards.

What is the new insurance law in Arizona?

On and after July 1, 2020, all new auto insurance policies that are issued or renewed must provided with at least 25/50/15 coverage limits. If your current coverage limits are below the new required coverage limits, your coverage limits will automatically be increased to the minimums when your policy renews.

How do I file proof of claim in Arizona?

There are two ways a Proof of Claim may be filed with the court: by mailing or delivering a paper copy of the Proof of Claim form to the Clerks Office in Phoenix, Tucson or Yuma; or by using our online Electronic Proof of Claim (ePOC) application.

What is the function of the insurance department?

The major goals of insurance departments are to ensure fairness in rates and access to coverage, fairness and timeliness in claims handling, solvency of carriers, education of professionals, and to educate consumers. The insurance department must authorize an insurer before it can issue policies in any given state.

What is the purpose of the Arizona Department of Insurance?

DIFIs mission is to protect consumers, provide certainty on regulatory matters, and perform with efficiency and integrity as good stewards of taxpayers resources.

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Who regulates insurance in Arizona?

The Arizona Department of Insurance (Department) regulates and monitors insurance companies and professionals operating in Arizona to protect the public and help ensure that these entities comply with State and federal laws.

Insurance claim declaration - Arizona Department of Housing 2026

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