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Get Az Insurance Claim Declaration 2017-2026

Arizona Department of Housing Logo. Leading with Solutions. CONTACT US. Arizona Department of Housing. 1110 W. Washington #280. Phoenix, AZ 85007.

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How to fill out the AZ Insurance Claim Declaration online

Filling out the AZ Insurance Claim Declaration is an essential step in securing your financial assistance for your primary residence. This guide will walk you through the important components of the form and provide clear, step-by-step instructions to help you complete it easily online.

Follow the steps to accurately complete your declaration.

  1. Press the ‘Get Form’ button to obtain the form and open it in your preferred editor.
  2. In section a, provide your full name and the details of any previous financial assistance received from the Arizona Department of Housing, Arizona Housing Finance Authority, or the Arizona Home Foreclosure Prevention Funding Corporation.
  3. In section b, confirm that you currently reside at the address you listed in section a as your primary residence, or indicate if you have obtained a temporary waiver regarding residency requirements.
  4. In section c, enter the amount of the insurance claim payout you received, the name of the insurance company, and the date of the payout.
  5. In section d, describe the situation(s) that led to the insurance claim concerning your primary residence.
  6. In section e, specify how the claim funds will be used exclusively for making repairs to your primary residence.
  7. At the end of the form, sign, print your name, enter your email address, and provide the date. Don't forget to include your phone number in the designated space.
  8. After completing the form, save your changes, and download, print, or share the document as needed.

Complete your AZ Insurance Claim Declaration online today for a seamless experience.

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The Arizona Department of Insurance (Department) regulates and monitors insurance companies and professionals operating in Arizona to protect the public and help ensure that these entities comply with State and federal laws.

Claims Against the State of Arizona If you would like to file a claim against the State of Arizona, click here to obtain a Notice of Claim form. Notice of claim forms must be hand delivered or mailed to the Office of the Attorney General, 2005 N. Central Avenue, Phoenix, Arizona 85004.

Barbara D. Richardson joined the Arizona Department of Insurance and Financial Institutions (DIFI) as Cabinet Executive Officer (CEO) effective March 6, 2023. CEO Richardson previously served as the Insurance Commissioner for Nevada from March 2016 to December 2022.

Serve the Notice of Claim: The Notice of Claim must be served upon the public entity within 180 days of the date of the incident. This deadline is strict, and failure to serve the Notice of Claim within the required time frame may bar a claimant from pursuing a lawsuit against the public entity.

Arizona's Tort Claims Act, which is codified starting at Arizona Revised Statutes section 12-820, dictates very specific rules about when an injured person may (or may not) file a claim against the government. The statute also outlines situations in which the government has total immunity from lawsuits.

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