Flood rejection statement*  Please retype the following statement in the space below to reject Flood insurance. 
 
 
*I certify that I have been given the opportunity to purchase Flood insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it. 
Excess Flood Rejection Statement*  Please retype the following statement in the space below to reject Excess Flood insurance. 
 
 
*I certify that I have been given the opportunity to purchase Excess Flood insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it. 
Earthquake rejection statement*  Please retype the following statement in the space below to reject Earthquake insurance. 
 
 
*I certify that I have been given the opportunity to purchase Earthquake insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it. 
Hurricane / Wind / Hail rejection statement*  Please retype the following statement in the space below to reject Hurricane / Wind / Hail insurance. 
 
 
*I certify that I have been given the opportunity to purchase Hurricane, Wind, and Hail insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it. 
Cyber rejection statement*  Please retype the following statement in the space below to reject Cyber insurance. 
 
 
*I certify that I have been given the opportunity to purchase Cyber insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it. 
Mold rejection statement*  Please retype the following statement in the space below to reject extra Mold insurance. 
 
 
*I certify that I have been given the opportunity to purchase extra Mold insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it. 
Home Systems/Equipment Breakdown rejection statement*  Please retype the following statement in the space below to reject Home Systems / Equipment Breakdown insurance. 
 
 
*I certify that I have been given the opportunity to purchase Home Systems / Equipment Breakdown insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it. 
Personal Umbrella rejection statement*  Please retype the following statement in the space below to reject Personal Umbrella insurance. 
 
 
*I certify that I have been given the opportunity to purchase Personal Umbrella insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it. 
Extended Replacement Cost Coverage rejection statement*  Please retype the following statement in the space below to reject Extended Replacement Cost insurance. 
 
 
*I certify that I have been given the opportunity to purchase  Extended Replacement Cost coverage insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it. 
Guaranteed Replacement Cost Coverage rejection statement*  Please retype the following statement in the space below to reject Guaranteed Replacement Cost coverage insurance. 
 
 
*I certify that I have been given the opportunity to purchase Guaranteed Replacement Cost coverage insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it.