Download Forms
At Premier Group, we want to make things easy for you. That's why we have setup this page to give you the option of downloading applications and claim forms. Once you have filled out your applications/claim form, please FAX it to us at 215-663-9794. An account representative will get back to you within 24 hours or less.

NOTE: This site utilizes Portable Document Format (PDF) files for our comprehensive claim forms and applications than can either be saved, viewed and/or printed using Adobe Acrobat's Reader which is available free for the following platforms:

  • Windows®
  • Macintosh®
  • Sun(tm) Sparc®
  • HP/UX(tm)
  • Silicon Graphics®
  • IBM AIX
Adobe Acrobat

Click here to get your FREE copy of Adobe Acrobat Reader.

If you want to view the PDF file and have Acrobat Reader installed, simply click on the form below, and your browser will launch Acrobat Reader and the file you have selected. If you want to save the file, you may either save it while you're viewing the form in your browser, or simply right click your mouse on the link and save it to disk.


Click Specific Company Forms and Questionairs to download other non Acord insurance forms.

FORM #DESCRIPTION
80Homeowner Application
301Flood Insurance Application
81Personal Inland Marine Application
82Watercraft Application
83Personal Umbrella Application
84Dwelling Fire Application
85Mobile Home Application
90PAPennsylvania Personal Auto Application
60PAPennsylvania Uninsured Motorist Auto Application
61PAPennsylvania Supplimental (Tort Option, Med. Benefits, etc.)Auto Application
62PAPennsylvania Underinsured Motorist Auto Application
1Property Loss Notice
2Automobile Loss Notice
3General Liability Notice of Occurrence/Claim
4Workers Comp First Report of Injury or Illness
11Auto Accident Information Form (Keep copies in car)
12Exchange of Information Form (Keep copies in car)
13Witness Card (Keep copies in car)
18Jewelry Appraisal and Claim Evaluation
35Cancellation Request/Policy Release
36Agent/Broker of Record Change
41Residential Property Replacement Cost Worksheet
50Insurance Identification Card
60Flood Insurance Notice/Rejection
61PAPennsylvania Auto Supplement Summary of Coverages
70Personal Home Policy Change Request
71Personal Auto Policy Change Request
79Jewelry Insurance Appraisal
125Commercial Insurance Application - Applicant Info Section
126-sCommercial General Liability Section
126-nGeneral Liability Section
127Business Auto Section
128Garage and Dealers Section
129Vehicle Schedule
130Workers Compensation Application
131Commercial Umbrella Section
137PAPennsylvania Commercial Auto
138PAPennsylvania Garage and Dealers
140Property Section
141Crime Section
144Glass and Sign Supplement
145Accounts Receivable/Valuable Papers
146Equipment Floater Section
147Installation/Builders Risk Section
148Electronic Data Processing Section
160Business Owners Application
161Business Owners Supplemental App
163Commercial Auto Driver Information Schedule
165Small Commercial Account Package App
185Restaurant/Tavern Supplement
186Contractors Supplement
187Professional Liability Supplement
200Insurance Change Authorization Letter for Mortgagee
201Credit Card Payment Authorization Form
202Flood Zone Determination Application
202Insurance Binder
202Certificate of Liability Insurance

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800-220-9798 | 215-663-8998 | 215-663-9794 fax.