Follow the steps to complete your application seamlessly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Indicate whether this is a new application or a renewal by marking the appropriate checkbox.
3. Enter your F.O.P. ID number as well as the F.O.P. Lodge Name and number. This ensures proper identification and processing of your application.
4. Fill in your full name, home address, city, state, and zip code. Ensure all information is accurate and clearly typed or printed.
5. Provide your email address and phone number for any correspondence related to your application.
6. Input your Social Security number and the name of your law enforcement agency.
7. Answer whether you are a full-time peace officer by selecting ‘Yes’ or ‘No.’ Remember that coverage is available only to currently employed peace officers.
8. Select your desired coverage limit by choosing from the options available: $100,000, $250,000, or $500,000, and review the corresponding premium costs.
9. Confirm your understanding of the application terms by signing the form. This indicates that you agree the provided information is accurate.
10. Prepare your payment by making checks or money orders payable to Hylant Group, and mail the completed application along with payment to the specified address.
11. After completing the form, save any changes, and consider downloading or printing a copy for your records.

Complete your Fop Moonlighting Insurance application online today to ensure you have the necessary coverage.