ACORD 65MA Instructions

ACORD 65 MA (2005/01) – Massachusetts Property InsuranceUnderwriting Association

Application for Dwelling Fire Insurance Inspection and Placement

Use this form to apply for Dwelling Fire insurance with the Massachusetts Property Insurance Underwriting Association.

See also ACORD 66 MA for use instructions and required disclosure notices. ACORD 66 MA must be used with ACORD 65 MA.