Notice to Deceased's Homeowner's Insurance Company

Date: __________________

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[insert insurance company name and address]

Name of deceased: _____________________________
Deceased's Address:	_____________________
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Deceased's Social Security number: _________________
Date of death: _________

Homeowner's insurance policy number: __________________

This letter is to notify you that your insured, ________________________ [deceased’s name], has died. I am the executor of the estate and would like to be added as a named insured to the above-referenced homeowner's insurance policy. Enclosed with this letter you will find a certified death certificate for ______________________ [deceased’s name].
Please contact me so that we may discuss this matter. I can be reached using the information listed below. Please sign and return the second copy of this letter in the enclosed stamped and self-addressed envelope.
Thank you for your assistance.

Signature: ___________________________________________
Printed or typed name: ____________________________
Relationship to deceased: ____________________________
Address:	____________________________
____________________________
Home phone: ________________	Work phone: ____________________
Email: _______________________________

Receipt acknowledged by

Signature: __________________________________________
Printed or typed name: _________________________
Date: _______________________
Title: _______________________