ACORD 80 (2016/11) Fillable Homeowner Application Form Online

Homeowner Application

ACORD 80 (2016/11)

Personal Lines

November 2016

02 page

PDF, Fillable PDF


An Acord 80 form serves as an application to apply for homeowner insurance, including liability, personal property, and equipment. The form ensures the desired coverage to protect home and personal property from financial loss. Insurance agents or insurers require the form to analyze the applicant’s property details and risk profile to calculate premiums. The Accord 80 application helps homeowners looking for new policies or switching insurers.


The applicant’s data and property details help the insurers to analyze risks for tailored coverage.

The accurate property details and loss history avoid miscommunication during the claim process.

The addition of a mortgagee on the acord 80 form fulfills the lender’s requirements to purchase a new home.

The fillable Acord homeowner application PDF saves more time due to online completion and submission.


The agency’s details ensure transparent communication with the insurance agents or brokers.

The applicant’s details provide accurate identity and risk-related information for insurance coverage.

Ensure that the property is insured, which helps the insurers to assess the replacement cost for coverage.

Records the insurance coverage and limits for protection and premium calculations.

Includes insurance claims or losses details to evaluate risks and premium adjustments.

Records the additional interest, mortgagee, or loss payee details to notify the lenders or lienholders of protection.

Contains additional risk-related information that allows insurers to determine unique risks and tailor coverage.


  1. Write the agency’s name, address, phone number, fax number, and customer ID.
  2. Mention the insured’s name, address, policy number, effective date, expiration date, and facility code.
  3. Mention the policy type, effective date, and the property’s last inspection date.
  4. Write the applicant’s name, date of birth, residential address, phone number, email, and employer details.
  5. Write the limits, premiums, and deductibles for customized coverage.
  6. Mention the forms and endorsement details, including location, vehicle, and boat number.
  7. Write the billing account number, source, plan, method, and deposit amount.
  8. Write the property details to underwrite the insurance policy.
  9. Mention the location of the property.
  10. Write the loss history, including date, type, description, and amount paid.
  11. Mention the optional coverage type and its premium.
  12. Mention the answers to the general questions.
  13. Write the additional interest’s details, including name, address, and their interest in items.
  14. Mention the remarks for enhanced coverage.
  15. Ensure the applicant’s and producer’s signatures.

Yes, the application can be used for a seasonal or secondary residence, providing the details in the specific fields.

Yes, the property information section includes construction and completion status details.

If no claim has been filed, mention “NO” to confirm, ensuring clarity for underwriters.

You can leave the additional interest section blank for easy underwriting if there is no mortgage.

You must contact your insurance agent to provide the revised form to correct errors for accurate insurance coverage.

Related Forms

Policyholders require the Acord 70 form to request that insurers change their personal insurance policies (except auto).

Policyholders require the fillable acord form to request policy changes, including adding vehicles, updating driver information, or modifying coverage limits

Insurers, agents, or policyholders use the Acord fraud statement form in various states to ensure transparency and reduce fraudulent activities