____________________, 20___ (Date of Letter) ______________________________ (Name of Bank) ______________________________ (Attn: Insurance Department) ______________________________ (Street Address) ______________________________ (City, State and Zip Code) RE: _________________________________________ (Insurance Coverage) Dear Insurance Agent: As you know, the undersigned acquired insurance coverage on his/her ____________________(house, auto, boat, plane, farm, outbuildings, etc.) through your bank in conjunction with a loan on said item as of the _____ day of ________________, _____(year). Evidence of the insurance coverage may have been received by the bank; however, to date, the undersigned has not received evidence of insurance coverage on this item. Since coverage is important to both the banking institution as well as the undersigned, it would seem appropriate that a copy of coverage verification be provided to the undersigned pursuant to this request. A full and complete copy of the insurance policy, the policy number and the declaration sheet will be necessary in order for me (us)to complete our personal records. Please provide copies or the originals. In addition to the policy, kindly indicate a precise amount that is deducted from our payments on a _________________ (monthly, quarterly, semiannual, annual) basis for this insurance payment. Also indicate the date when payments fall due and explain the process and/or procedure used in assuring compliance with the payment of the insurance premiums. Thank you in advance for your cooperation. Very truly yours, ______________________________ (Signature) ______________________________ (Address) ______________________________ (City, State and Zip Code) ____________________________ (Phone Number) LAWCHEK, LTD. LETTER PRO Samples, Copyright 2006 This is not a substitute for legal advice. An attorney must be consulted.