Form Change Sheet FEMA Form 086-0-2

FEMA Form 086-0-2, CANCELLATION/NULLIFICATION REQUEST FORM

LOCATION	CURRENT TEXT	REVISED OR ADDED TEXT
Top of form, Page 1		Changed color of banners from a dark orange to a warm gray.
		Changed the font and point size to be consistent with all four NFIP forms.
		Changed color of the line “FLOOD INSURANCE APPLICATION” to match the color of the banners on the form.
		Changed color of the line “IMPORTANT – PLEASE PRINT OR TYPE” back to black
Current Policy Number box, Page 1	CURRENT POLICY NUMBER	Changed to: POLICY #:____________
Top of form; left side, Page 1		Removed: Statement “IF THIS POLICY IS CANCELED BY THE INSURED THROUGH HIS OR HER AUTHORIZED REPRESENTATIVE, IT SHALL REMAIN IN FORCE FOR THE BENEFIT OF THE MORTGAGEE (OR TRUSTEE) FOR 30 DAYS AFTER WRITTEN NOTICE TO THE MORTGAGEE OR TRUSTEE OF SUCH CANCELLATION AND THEN CEASE. SEE REVERSE SIDE FOR PRIVACY STATEMENT”.
Top of form, Page 1	IMPORTANT—PLEASE PRINT OR TYPE	Changed to: IMPORTANT—PLEASE PRINT OR TYPE; ENTER DATES AS MM/DD/YYYY.
Policy Term, Page 1	POLICY TERM	Changed to: POLICY PERIOD
Policy Period, Page 1		Removed: MM, DD, and YYYY from date lines.
Agent Information, Page 1	AGENT INFORMATION	Changed to: AGENT/PRODUCER INFORMATION
Agent/Producer Information, Page 1	NAME, MAILING ADDRESS, PHONE NO., AND FAX NO. OF LICENSED PROPERTY OR CASUALTY INSURANCE AGENT/BROKER WHOSE POLICY IS BEING TERMINATED:	Changed to: NAME AND MAILING ADDRESS OF AGENT/PRODUCER ON THE POLICY BEING CANCELED.
		Added: AGENCY NO.: _____________ AGENT'S TAX ID: ___
		Added: EMAIL ADDRESS: __________
First Mortgagee, Page 1	FIRST MORTGAGEE	Changed to:1st MORTGAGEE
Property Location, Page 1		Moved the box from the left side of the form to the right.
2nd Mortgagee/Other, Page 1	OTHER PARTIES NOTIFIED	Changed to: 2nd MORTGAGEE/OTHER Moved: the box from the left side of the form to the right.
	LIST OTHER PARTIES NOTIFIED	Changed to: NAME AND MAILING ADDRESS OF OTHER PARTIES NOTIFIED:
Cancellation Reason Code, Page 1	CANCELLATION REASON CODE	Changed to: CANCELLATION REASON CODES
		Removed: Statement “THIS POLICY MAY ONLY BE CANCELED UPON TERMINATION OF THE INSURED'S OWNERSHIP IN THE PROPERTY COVERED AT THE LOCATION DESCRIBED ON THE DECLARATIONS PAGE OF THE POLICY FOR REASON CODES (1) AND (2) BELOW”.
Signature, Page 1	THE ABOVE STATEMENTS ARE CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT ANY FALSE STATEMENT MAY BE PUNISHABLE BY FINE OF IMPRISONMENT UNDER 18 U.S. CODE, SECTION 1001. INSURANCE AGENT ALSO CERTIFIES THAT ITEMS ON THE REVERSE HAVE BEEN DISCUSSED WITH INSURED.	Changed to: THE ABOVE STATEMENTS ARE CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT ANY FALSE STATEMENTS MAY BE PUNISHABLE BY FINE AND/OR IMPRISONMENT UNDER APPLICABLE FEDERAL LAW. SEE REVERSE SIDE OF COPIES 2, 3, AND 4.
		Added: ADDITIONAL INSURED SIGNATURE. Removed: AGENT/BROKER TAX ID:
	SIGNATURE OF AGENT/BROKER	Moved: SIGNATURE OF AGENT/BROKER to the bottom of the form, and changed it to SIGNATURE OF AGENT/PRODUCER
Bottom of form, Page 1
	SPECIAL NOTE TO INSURANCE AGENT:	Changed to: SPECIAL NOTE TO INSURANCE AGENT/BROKER:

0