Regulation .04 Standard Antiarson Application—Part 2.
Regulation .04 Standard Antiarson Application—Part 2.LinkCopy Citation
STATE OF MARYLAND
STANDARD ANTIARSON APPLICATION
PART 2
A.
Ownership Information:
1.
Check the type of ownership for the insured property:
2.
Complete the following for all those possessing an ownership interest of 10% or more, except that all owners should be listed for closed corporations and beneficiaries.
3.
Have any of the owners listed above:
a.
Within the past ten years, claimed any fire loss for the destruction of 25% or more of any insured property?
b.
Been convicted of any crimes?
4.
Mortgage Payments:
5.
Unrecorded Mortgages:
6.
Taxes (include Real Estate, Water, Sewer, Special Privilege, etc.):
7.
Is the building for sale?
B.
Vacancy.
1.
Indicate seasonal period (if any) when building is unused:
2.
For apartment buildings indicate:
3.
For other buildings indicate percent vacant:_____
4.
For all buildings indicate the following:
a.
Reason for vacancy/unoccupancy:______________
b.
Anticipated date of occupancy:_______________
c.
If the building is vacant or unoccupied, indicate how it is protected from unauthorized entry_________________
________________________________________________________
C.
Additional Property Description:
1.
Is water, sewage, electricity, or heat out of service?
2.
Is there unrepaired damage or have items been stripped from the building?
3.
Are any violations outstanding with regard to the Fire, Building or Health Code?
4.
Is there a governmental order to vacate or destroy the building or has the building been classified uninhabitable or structurally unsafe?
D.
Other Policies:
1.
List all other policies which insure this property against fire loss:
2.
List all real estate transactions during last 3 years involving this property: