Get Animal Mortality Application

The Animal Mortality Application is an essential document for those looking to secure coverage for livestock. This guide provides clear, step-by-step instructions for filling out the application online, ensuring that users understand each section and field.

Follow the steps to successfully complete the application.

1. Press the ‘Get Form’ button to obtain the Animal Mortality Application and open it for editing.
2. Enter the producer's name and applicant's name in the appropriate fields to identify the person or entity submitting the application.
3. Provide the agency code and Federal Employer Identification Number (FEIN) or Social Security Number (SOC SEC #) to ensure proper processing.
4. Fill in the mailing address, including city, state, and zip code for effective communication.
5. Input your contact details such as phone number, fax number, and email address for ease of follow-up.
6. Select your entity type from the options provided — individual, partnership, corporation, limited liability corporation, or other.
7. Indicate the proposed effective date of coverage and select the type of mortality protection desired (full or limited).
8. Provide positive identification for each animal listed, including sire and dam details, registration numbers, tattoos, or microchips, as required.
9. Specify details about each animal, including its name, breed, date of birth, purchase price, sex, date acquired, and desired insurance amount.
10. Respond to questions about ownership and prior insurance coverage, ensuring to provide accurate information about any claims or refusals by other carriers.
11. Complete the veterinarian’s statement of examination, which includes detailed examination questions to assess the health status of the animal.
12. Review the application for accuracy, ensuring all fields are completed as required before submitting.
13. After filling out the application, save your changes, and download, print, or share the form as needed.

Complete your application online today to secure your livestock with the necessary coverage.