Client Info

The Client Info page includes the following forms:

Client Information
Lienholder
Additional Insured
Agent Billing Option

Client Information

The Client Info form provides a place for you to enter some final required details about the applicant.

To enter Client Information:

Complete the Client Info form.

Client Info includes:

Label	Description
Have you had any other policies with American Modern?	Indicates if applicant has had prior insurance with American Modern.
First Name	Applicant's first name.
Middle Initial	Applicant's middle initial.
Last Name	Applicant's last name.
Additional Name/Address Information	An additional field for name or address information overflow.
Is mailing address same as location address?	Indicates if the applicant's address is the same as the property location address.
Mailing Address	Applicant's address street number.
Mailing City	Applicant's address city.
Mailing State	Applicant's address state/country.
Mailing Zip Code	Applicant's address ZIP code.
Home Phone	Applicant's home phone number.
Work Phone	Applicant's work phone number.
Date of Birth	Applicant's date of birth.
Social Security Number	Applicant's social security number.
Marital Status	Indicates applicant's marital status.
Occupation	Indicates the applicant's occupation.
Secondary Date of Birth	Spouse/secondary date of birth.
Secondary Social Security Number	Spouse/secondary social security number.

Do one of the following:
If a lienholder for the property exists, complete the Lienholder form.
If an Additional Insured exists, complete the Additional Insured form.
Follow the steps to select the Agent Billing Option.

Lienholder (Loss Payee, Mortgagee)

The Lienholder form provides a place for you to enter information about a property lienholder, if one exists. A maximum of two lienholders can be added.

Designation of a lienholder is considered an acknowledgement that the entity named has a legal interest in the home due to an installment sales contract or other valid security by the amount of the loss under the appropriate coverage.

To enter Lienholder information:

Complete the Lienholder form.

Lienholder information includes:

Label	Description
Name	Lienholder's name. Designation of a lienholder is considered an acknowledgment that the entity named has a legal interest in the home due to an installment sales contract or other valid security by the amount of the loss under the appropriate coverage.
Address	Lienholder's street address.
City	Lienholder's address city.
State	Lienholder's address state/country.
Zip	Lienholder's address ZIP code.
Loan Number	Enter the loan number of the loan supplied to the applicant by the lienholder.
Is lienholder other than financial institution?	Select Yes to indicate that the lienholder is NOT a financial institution.

Do one of the following:
- If an Additional Insured exists, complete the Additional Insured form.
- Follow the steps to select the Agent Billing Option.

Additional Insured

The Additional Insured form provides a place for you to enter information about any other parties who have a financial interest in the property.

To enter Additional Insured information:

Complete the Additional Insured form.

Additional Insured information includes:

Label	Description
Name	The name of the additional people who have a financial interest in the property being insured.
Address	The street address of the additional people who have a financial interest in the property being insured.
City	The address city of the additional people who have a financial interest in the property being insured.
State	The address state of the additional people who have a financial interest in the property being insured.
Zip	The address ZIP code of the additional people who have a financial interest in the property being insured.

Follow the steps to select the Agent Billing Option.