Request for Evidence of Property

Please complete the short form below and we will process your request during regular business hours: M-F 8am-5pm EST. Please note that it can take 48-72 hours to fulfill this request due to weekends, etc, however we will attempt to respond much sooner.

    Do you also need a Certificate of Liability?
    YesNo

    Name of Insured or Unit Owner:

    Address of Property (please include Unit Number if applicable):

    Mortgage Loan Number:

    Mortgagee clause:

    Name, phone number and direct email address of person requesting evidence:
    Your Name
    Your Phone
    Your direct email

    Please provide fax or email address where evidence should be forwarded:

    Additional Comments:

    FOR A REFINANCE, A SIGNED AUTHORIZATION BORROWER'S AGREEMENT IS REQUIRED FROM THE INSURED TO ALLOW US TO PROVIDE THE INFORMATION YOU ARE REQUESTING, PLEASE EMAIL IT TO: insurance@wellsins.com OR FAX TO 910-254-9404.

    Please allow 24 to 48 hours for the Evidence to be forwarded; if you require the information sooner, please call our office during regular business hours 8am-5pm EST Monday through Friday.

    *Please note that we can not bind coverage or accept any policy changes or claims through this contact form. Unencrypted e-mail is susceptible to viewing by unauthorized parties.

    To ensure your confidentiality, it is important that you do not provide any information you consider confidential and/or personal in nature (i.e. Social Security Number, claim number, etc.) via e-mail or through this form.
    You may however, send us this type of information via phone, fax or mail.

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