Section 13, Part B - Tenant's Insurance - Detailed Questions

Section 13, Part B collects detailed information on tenant's insurance policies reported in Part A.

For definitions Information Booklet »

What is the name of the insurance company for "your (1st, 2nd, 3rd)" tenant's policy listed? [enter text] ____________________
* Enter name of insurance company, not the insurance agent.

What type of policy is this?

  1. Policy for someone INSIDE the CU
  2. Policy you no longer have
  3. Policy for someone NOT IN YOUR CU

Are the policy premiums paid -

  1. Entirely by you or your CU?
  2. Partially by you or your CU and partially by someone outside your CU?
  3. Entirely by an employer or union?
  4. Entirely by another group or persons outside your CU?

Are any premiums paid through payroll deductions?

  1. Yes
  2. No

How often are premiums on this policy paid?

  1. Weekly
  2. Biweekly
  3. Monthly - directly
  4. Monthly - in mortgage payment
  5. Quarterly
  6. Semiannually
  7. Annually
  8. Paid-up policy
  9. Other - Specify

* Specify: [enter text] ___________

Since the first of the reference month, what was your or your CU total expense for this insurance policy? [enter value] ______________

* Enter the actual amount the CU paid. Do not include any expenses paid for the CU by others

How much was paid this month? [enter value] ______________

End of Section 13B Tenant's Insurance

Go to Section 13 Part B - Other Type of Insurance »

Go to Section 14 Part A.1 - Hospitalization and Health Insurance »

Go to CAPI Home Page »

 

Last Modified Date: October 11, 2005