grant program


Application Instructions

An electronic version of the application can be found on this Web site. Applicants choosing to mail or fax their applications should contact NYPIUA, C-MAP Administrator, at (212) 208-9700 to request a copy of the application.

Guide for Completing C-MAP Applications

1. Applicant Information

Homeowners must provide their name, mailing address, phone numbers, and location of property requiring insurance. Use “Address Line 2” for irregular or long addresses.

Provide previous address if you have lived at the property less than three (3) years.
Provide employment information for yourself and any co-applicant.

Provide marital status, date of birth, and social security number for yourself and any co-applicant.

2. Location Information

Provide the location of property if it is different from the mailing address given above.

Give the distance the property is located from the shore. The term “shore” refers only to salt-water ocean, sound, bay, or inlet with distance measured from the normal high-tide mark.

If this property is one that you are contracted to purchase, provide the name of the company insuring the home for the current owner.

If you are the current owner and coverage was canceled, non-renewed, or conditionally non-renewed, supply the name of the insurance company, policy number, expiration date, and reason for termination. Homeowners whose policies were canceled as a result of failure to pay premium do not qualify for C-MAP placement.)

If you are a New York Property Insurance Underwriting Association (NYPIUA) policyholder, provide the policy number and expiration date.

Flood insurance is necessary for property located in A or V zones as indicated on Federal Flood Insurance Maps. Please provide the policy number, expiration date, amount of coverage. The amount of flood insurance coverage must be for the actual cash value of the property, including contents, up to the maximum amount available under the Flood Insurance program.

3. Coverages / Limits of Liability Requested

Indicate the Homeowners policy form you require.

Show the amount of coverage requested in each category.

4. Rating / Underwriting

This information allows the underwriter evaluating your application to establish the premium for your policy.

If you are applying for replacement cost coverage, this entire section must be completed.

5. General Information

Information in this section helps determine whether the property meets company underwriting guidelines. Use the “Remarks” section at the end of the form to explain all “Yes” answers as required.

6. Loss History

Please provide all information requested. Use the “Remarks” section if additional space is needed.

7. Additional Interest

Identify any additional interests to the property or mortgagees. Be sure that mortgagee name and address information is current.

8. Company Declinations

To assist us with the assignment of this application to companies for their evaluation, please list the company(ies) that have declined to insure this property.

9. Remarks

Use this section to detail information required in other areas of the application.

10. Broker-of-Record

While not mandatory, employing the services of an agent or broker to help you obtain insurance coverage is advisable before applying to C-MAP.

This section is completed only if you are represented by an insurance agent or broker.

11. C-MAP Application Affirmation Statement

Please read the statements on the application regarding the submission of this application and the information provided.

When you and your insurance agent or broker, if any, type your name and provide the last four (4) digits of your Social Security number(s), you are validating this application with a unique electronic signature. You are agreeing that signing the application with your electronic signature has the same validity and effect as signing the application by hand in ink.

Fill Out Application

Back to home page