ACORD 72 Instructions


Universal wording updates to improve clarity and intent were made to all FIG text for this form on 10/30/2009.
Section Name Field Name Field and/or Section Description
TITLE ACORD 72 (2009/10) Mobile HomeSupplement The titile of the form. ACORD 72, Mobile Home Supplement, is used with ACORD 89, Residential Section or ACORD 80, Homeowners Application, to provide information about mobile homes and the type of tie-down protection provided for the mobile home. Consult your company as to when this supplement is required.
IDENTIFICATION Agency Customer ID Enter identifier: The customer’s identification number assigned by the producer (e.g. agency or brokerage).
IDENTIFICATION Loc # Enter number: The producer assigned number of the location. As used here, the location number of the risk’s location as it appears on ACORD 88, Personal Insurance Application, Applicant Information Section or ACORD 80, Homeowners Application.
IDENTIFICATION Date Enter date: The month/day/year on which the form is completed. (MM/DD/YYYY)
IDENTIFICATION Agency Enter text: The full name of the producer/agency.
IDENTIFICATION Policy Number Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number.
IDENTIFICATION Effective Date Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence.
IDENTIFICATION Carrier Enter text: The insurer’s full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer’s group name or trade name.
IDENTIFICATION NAIC Code Enter code: The identification code assigned to the insurer by the NAIC.
IDENTIFICATION Named Insured(s) Enter text: The named insured(s) as it/they will appear on the policy declarations page.
MOBILE HOME RATING / UNDERWRITING Property Address – Street Enter text: The first address line of the physical location. As used here, Property Address should include: Street number, if any; Pre-direction, if any (example: 150 N Central Ave); Street name, if any; Street type (e.g.: st., rd, ave.) ; Post-direction, if any (e.g.: 150 Central Ave N); City; County; State; ZIP code If the address does not have a street number and name, provide sufficient information anddirections so that the property can be physically located. Provide legal description if required by the mortgage holder.
MOBILE HOME RATING / UNDERWRITING Property Address – City Enter text: The city of the physical location.
MOBILE HOME RATING / UNDERWRITING Property Address – County Enter text: The county of the location.
MOBILE HOME RATING / UNDERWRITING Property Address – State Enter code: The state or province of the physical location.
MOBILE HOME RATING / UNDERWRITING Property Address – Zip+4 Enter code: The postal code of the physical location.
MOBILE HOME RATING/UNDERWRITING New (Y / N) Enter Y for a “Yes” response. Input N for “No” response. Indicates if the mobile home was purchased new.
MOBILE HOME RATING/UNDERWRITING Year Enter year: The model year of the mobile home.
MOBILE HOME RATING/UNDERWRITING Make Enter text: The name of the manufacturer of the mobile home.
MOBILE HOME RATING/UNDERWRITING Model Enter text: The manufacturer’s model name for the mobile home.
MOBILE HOME RATING/UNDERWRITING ID Number Enter identifier: The serial number for this mobile home.
MOBILE HOME RATING/UNDERWRITING Length Enter number: The length of the mobile home expressed in feet.
MOBILE HOME RATING/UNDERWRITING Width Enter number: The width of the mobile home expressed in feet.
MOBILE HOME RATING/UNDERWRITING Doublewide Enter Y for a “Yes” response. Input N for “No” response. Indicates if the mobile home is a doublewide construction.
MOBILE HOME RATING/UNDERWRITING Skirted Enter Y for a “Yes” response. Input N for “No” response. Indicates if the mobile home is skirted.
MOBILE HOME RATING/UNDERWRITING # of Bedrooms Enter number: The number of bedrooms in the mobile home.
MOBILE HOME RATING/UNDERWRITING Tie Down – None (checkbox) Check the box (if applicable): Indicates the mobile home has no tie downs.
MOBILE HOME RATING/UNDERWRITING Full (checkbox) Check the box (if applicable): Indicates the mobile home tie downs are full.
MOBILE HOME RATING/UNDERWRITING Chassis Only (checkbox) Check the box (if applicable): Indicates the mobile home tie downs are chassis only.
MOBILE HOME RATING/UNDERWRITING Overtop Only (checkbox). Check the box (if applicable): Indicates the mobile home tie downs are overtop only.
MOBILE HOME RATING/UNDERWRITING Permanent Connection – Electricity (checkbox) Check the box (if applicable): Indicates the mobile home has a permanent connection to electricity.
MOBILE HOME RATING/UNDERWRITING Water (checkbox) Check the box (if applicable): Indicates the mobile home has a permanent connection to water.
MOBILE HOME RATING/UNDERWRITING Sewer (checkbox) Check the box (if applicable): Indicates the mobile home has a permanent connection to the sewer.
MOBILE HOME RATING/UNDERWRITING Cooking Location – End (checkbox) Check the box (if applicable): Indicates the mobile home has a cooking location at the end of the residence.
MOBILE HOME RATING/UNDERWRITING Middle (checkbox) Check the box (if applicable): Indicates the mobile home has a cooking location in the middle of the residence.
MOBILE HOME RATING/UNDERWRITING None (checkbox) Check the box (if applicable): Indicates the mobile home has no cooking location.
MOBILE HOME RATING/UNDERWRITING Mobile Home Foundation -Continuous Masonry Check the box (if applicable): Indicates the foundation is continuous masonry.
MOBILE HOME RATING/UNDERWRITING Mobile Home Foundation – Post & Pier Check the box (if applicable): Indicates the foundation is post and pier.
MOBILE HOME RATING/UNDERWRITING Mobile Home Foundation – Other Check the box (if applicable): Indicates the foundation is other than those listed.
MOBILE HOME RATING/UNDERWRITING Mobile Home Foundation – Other Description Enter text: The foundation of the mobile home.
MOBILE HOME RATING/UNDERWRITING Mobile Home Park Name Enter text: The name of the mobile home park.
MOBILE HOME RATING/UNDERWRITING Date Park Established Enter date: The date the mobile home park was established.
MOBILE HOME RATING/UNDERWRITING Number of Permanent Spaces in Park Enter number: The number of permanent spaces in the mobile home park.
MOBILE HOME RATING/UNDERWRITING Consecutive Months Occupied Each Year Enter number: The number of consecutive months the mobile home is occupied each year.
GENERAL INFORMATION -MOBILE HOME 1. Does mobile home park have a resident manager? Enter Y for a “Yes” response. Input N for “No” response. Indicates the answer to the question, “Does the mobile home park have a resident manager?”.
GENERAL INFORMATION -MOBILE HOME Manager’s Name Enter text: The full name of the manager of the mobile home park.
GENERAL INFORMATION -MOBILE HOME Phone Number Enter number: Thephone number of the manager of the mobile home park.
GENERAL INFORMATION -MOBILE HOME 2. Does mobile home park have limited access? Enter Y for a “Yes” response. Input N for “No” response. Indicates the answer to the question, “Does the mobile home park have limited access?”.
GENERAL INFORMATION -MOBILE HOME Description Enter text: An explanation of a response to a general information or underwriting question. Normally, “Yes” responses require an explanation.
GENERAL INFORMATION -MOBILE HOME 3. Does mobile home park have subdivisions? Enter Y for a “Yes” response. Input N for “No” response. Indicates the answer to the question, “Does the mobile home park have subdivisions?”.
GENERAL INFORMATION -MOBILE HOME Description Enter text: An explanation of a response to a general information or underwriting question. Normally, “Yes” responses require an explanation.
GENERAL INFORMATION -MOBILE HOME 4. Are roads unpaved in the mobile home park? Enter Y for a “Yes” response. Input N for “No” response. Indicates the answer to the question, “Are any roads unpaved in the mobile home park?”.
GENERAL INFORMATION -MOBILE HOME Description Enter text: An explanation of a response to a general information or underwriting question. Normally, “Yes” responses require an explanation.
CERTIFICATION OF MOBILE HOME TIE DOWNS 1. Is mobile home tied down? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is mobile home tied down? If yes, answer questions 2 through 13).”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 2. Is mobile home equipped with factory installed “under the skin” tie down strapping? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is mobile home equipped with factory installed “under the skin” tie down strapping?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 3. Type of Straps or Cables Used: 1 1/4 Steel Strap Check the box (if applicable): Indicates the type of straps used to tie down the mobile home are 1 1/4 steel strap.
CERTIFICATION OF MOBILE HOME TIE DOWNS 3. Type of Straps or Cables Used: 1 1/2 Steel Strap Check the box (if applicable): Indicates the type of straps used to tie down the mobile home are 1 1/2 steel strap.
CERTIFICATION OF MOBILE HOME TIE DOWNS 3. Type of Straps or Cables Used: 1/4 Steel Cable Check the box (if applicable): Indicates the type of cable used to tie down the mobile home are 1/4 steel cable.
CERTIFICATION OF MOBILE HOME TIE DOWNS 3. Type of Straps or Cables Used: 1/2 Steel Cable Check the box (if applicable): Indicates the type of cable used to tie down the mobile home are 1/2 steel cable.
CERTIFICATION OF MOBILE HOME TIE DOWNS 3. Type of Straps or Cables Used: Other Check the box (if applicable): Indicates the type of straps or cable used to tie down the mobile home is other than those listed.
CERTIFICATION OF MOBILE HOME TIE DOWNS 3. Type of Straps or Cables Used: Other, describe Enter text: The description of the type of straps or cable used to tie down the mobile home.
CERTIFICATION OF MOBILE HOME TIE DOWNS 4. Is all strapping used in tie downs galvanized? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is all strapping used in tie down galvanized?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 5. Is all strapping used in tie downs without perforations? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is all strapping used in tie downs without perforations?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 6. If cable used, are loose ends firmly clamped and secure? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “If cable used, are loose ends firmly clamped and secure?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 7. Are over the roof tie downs visible? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Are over the roof tie downs visible?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 7 a. If over the roof tie down are visible, are corner blocks of wood or metal used under strapping cable to prevent sharp bends? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “If over the roof tie down are visible, are corner blocks of wood or metal used under strapping cable to prevent sharp bends?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 8. Type of Anchors used for Tie Downs?: Dead Men Check the box (if applicable): Indicates the type of anchors used for the tie downs are dead men.
CERTIFICATION OF MOBILE HOME TIE DOWNS 8. Type of Anchors used for Tie Downs?: Screw Auger Check the box (if applicable): Indicates the type of anchors used for the tie downs are screw auger.
CERTIFICATION OF MOBILE HOME TIE DOWNS 8. Type of Anchors used for Tie Downs?: Other Tie Down Anchors Check the box (if applicable): Indicates the type of anchors used for the tie downs are other than those listed.
CERTIFICATION OF MOBILE HOME TIE DOWNS 8. Type of Anchors used for Tie Downs?: Explain Enter text: The description of the screw auger or other tie down anchors.
CERTIFICATION OF MOBILE HOME TIE DOWNS 9. Are turnbuckles used in tie downs? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Are turnbuckles used in tie downs?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 9 a. If turnbuckles are used in tie downs, are they forged steel? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “If turnbuckles are used, are they forged steel?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 9 b. Are turnbuckles ending with jaws properly secured? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Are turnbuckles ending with jaws properly secured?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 9 c. Do turnbuckles end with open hook? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Do turnbuckles end with open hook?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 9 d. If turnbuckles end with open hook, are they closed with twine or wire? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “If turnbuckles end with open hook, are they closed with twine or wire?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 10. Are there any additions to mobile home (including carport, added rooms, etc) tied down? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, ” Are there any additions to mobile home (including carport, added rooms, etc)?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 10 a. Are all additions to mobile home tied down? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Are all additions to mobile home (including carport, added rooms, etc.) tied down?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 11. Is mobile home properly blocked? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is mobile home properly blocked?”.
CERTIFICATION OF MOBILE HOME TIE DOWNS 11. Is mobile home properly blocked? If “NO”, explain Enter text: An explanation of a response to a general information or underwriting question. Normally, “Yes” responses require an explanation. As used here, explain if the mobile home is not properly blocked.
CERTIFICATION OF MOBILE HOME TIE DOWNS 12. How many properly secured straps or cables are there over the roof? Enter number: The number of properly secured straps or cables that are over the roof.
CERTIFICATION OF MOBILE HOME TIE DOWNS 13. Facing either end of the mobile home, how many properly secured frame tie downs are there? Right: Enter number: The number of properly secured frame tie downs on the right side when you are facing either end of the mobile home.
CERTIFICATION OF MOBILE HOME TIE DOWNS 13. Facing either end of the mobile home, how many properly secured frame tie downs are there? Left Enter number: The number of properly secured frame tie downs on the left side when you are facing either end of the mobile home.
IDENTIFICATION Agency Customer ID Enter identifier: The customer’s identification number assigned by the producer (e.g. agency or brokerage).
IDENTIFICATION Loc # Enter number: The producer assigned number of the location.
CERTIFICATION OF MOBILE HOME TIE DOWNS (Continued) Explanation of Items Not Adequately Described Above Enter text: An explanation of a response to a general information or underwriting question. Normally, “Yes” responses require an explanation. As used here, explain any items not adequately described above
CERTIFICATION OF MOBILE HOME TIE DOWNS (Continued) Signature of Owner / Applicant Sign here: Accommodates the signature of the applicant or named insured.
CERTIFICATION OF
MOBILE HOME TIE DOWNS
(Continued) Date Enter date: The date the form was signed by the named insured.
Edition Date The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM).