Real Estate Insurance Check

If you have received a check for repairs to a property mortgaged through CEFCU, please complete this form.

After you have completed the form, we will contact you with information you will need to process the check.

Please email CEFCU if you have questions about the form or the check you received or if the check is not made payable to you and CEFCU.

Starred (*) fields are required.

Insurance Information

Email CEFCU if the check is not made payable to you and CEFCU.

Is the check made payable to you and CEFCU?

Yes No

Address of affected property*

CEFCU Mortgage Type*

Select one... First Second Hybrid HELOC

Check Amount*

Does the check cover your full claim?

Yes No

Level of damage to property*

Select one... Total/near-total loss: Not habitable. Moderate structural damage: Not habitable but still standing. Minor damage: Habitable but needs repairs.

Description of Damage*

Estimated amount to repair*

Who will repair*

Select one... Home owner Contractor Home owner and Contractor Repairs complete

Your Information

Full Name*

Phone*

Email*

Temporary Address
(if applicable)

Preferred method of contact

Phone Email

Best time to contact

Select one... Morning Afternoon Evening

Street:

Additional Details

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