Certificate Request Form

Please enter all information:

Please enter the following information to request an Associations Certificate from American Benefits Insurance. Borrower information must be complete and accurate to produce a certificate. Requests are processed and faxed within 1-2 business days. If you have any questions, please feel free to contact us as (503) 292-1580.

Need a RUSH certificate within 4 business hours? An additional $20 fee will apply.

1. Association or Home Owners' Information:
2. Borrower Information
3. First Lender / Mortgage Clause Information
What is the mortgage clause type? *
Why are you requesting the certificate? *
4. Second Lender / Mortgage Clause Information
5. Your Contact Information
User Flood Info
6. How would you like to receive your certificate?
Please select at least one method.
(Standard Request processed in 1-2 business days)

For Rush Delivery*, Please complete and submit the form above, then pay with PayPal after you click submit.

*Rush orders are processed during normal business hours (M-F 9am-5pm).

Delivery will be within 4 regular business hours following an order. (Example: an order on Monday at 9am will be delivered by Monday at 1pm, while an order on Friday at 4pm may not arrive until Monday at 12noon.)