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Germania Mutual Insurance

Insurance Forms

 Please download or print any of the application or supplemental forms, and provide them to your nearest broker. 

After Hours Claim Reporting (pdf)

Download

Cancellation of Insurance Form (pdf)

Download

Certificate of Insurance (pdf)

Download

Farm Insurance Application (pdf)

Download

Home, tenant, seasonal, general dwelling and condominium insurance application (pdf)

Download

Mobile Home Insurance Application (pdf)

Download

Oil Tank Insurance Questionnaire (pdf)

Download

Outdoor Water Heater Questionnaire (pdf)

Download

Privacy Disclosure & Consent Form (pdf)

Download

Privacy Act (pdf)

Download

Release of Interest (pdf)

Download

Sewer Backup Questionnaire (pdf)

Download

Stove and Chimney Questionnaire (pdf)

Download

Vacancy Questionnaire (pdf)

Download

Pre-Authorized Debit Forms

Please see our forms for Pre-Authorized Payment arrangements

PAD Form (pdf)

Download

Copyright © 2020 Germania Mutual Insurance Co. - All Rights Reserved.

Located at 139 Kaiser William Ave in Langenburg, SK.   Contact us at 306-743-5363 for your Insurance needs!

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