New Brighton, PA · Beaver County
Application for Fire Insurance Proceeds Certificate
Property owners use this application to request a Fire Insurance Proceeds Certificate from the Borough of New Brighton after a fire.
What this form is
This application requests a Fire Insurance Proceeds Certificate from the Borough of New Brighton for an insured property affected by fire. The form asks for owner and property details, insurance company and policy information, the fire date and loss amount, and whether the owner plans to rebuild or demolish. Requests must be submitted in writing on this form; the Borough says it will respond in writing within fourteen working days.
Who needs it
Property owners seeking a Fire Insurance Proceeds Certificate from the Borough of New Brighton must submit this written application.
How to submit it
Submit the completed form in writing to the Borough of New Brighton, 610 Third Avenue, New Brighton, Pennsylvania 15066, or fax it to (724) 847-5128.
About notarization
The insurer signs and dates this application without a notary; the form lists no notarized attachment or sworn step.
How to submit this form
- 1
Download The Application
Download the Fire Insurance Proceeds Certificate application.
- 2
Complete The Form
Enter the property owner, insured property, insurance, fire, loss, and rebuilding or demolition information.
- 3
Get The Insurer's Signature
Have the insurer sign and date the application.
- 4
Submit The Application
Submit the completed form in writing to the Borough address or fax listed on the form.
Frequently asked questions
- What is the Fire Insurance Proceeds Certificate application?
- It is a written request to the Borough of New Brighton for a Fire Insurance Proceeds Certificate for an insured property affected by fire.
- Who should complete this application?
- Property owners requesting a certificate should provide owner, property, and insurance details. The form also includes a signature and date line for the insurer.
- Do I need a notary for the Fire Insurance Proceeds Certificate application?
- No. The insurer signs and dates this application without a notary, and the form lists no notarized attachment or sworn step.
- How do I submit the Fire Insurance Proceeds Certificate application?
- Submit the completed form in writing to the Borough at 610 Third Avenue, New Brighton, Pennsylvania 15066, or fax it to (724) 847-5128.
Need something notarized?
This Application for Fire Insurance Proceeds Certificate doesn’t need a notary — but if you have another New Brighton form that does, a commissioned online notary can help.