Official Louisiana Military Discount Template in PDF Fill Out My Document Online

Official Louisiana Military Discount Template in PDF

The Louisiana Military Discount form is a document designed for active military personnel to apply for discounts on personal automobile liability insurance. This form requires the completion of various sections, including personal information and verification of military status. To take advantage of this benefit, individuals should fill out the form by clicking the button below.

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Structure

Document Overview

Fact Name Description
Form Purpose The Louisiana Application for Military Discount allows active military personnel to apply for discounts on personal automobile liability insurance policies.
Eligibility Criteria To qualify, applicants must be on active duty, permanently based in Louisiana, and meet the definition of "active military personnel" as per LSA-R.S. 22:1482.
Required Information Applicants must provide their full name, date of birth, home address, and phone number. Sections for spouse and dependents must also be completed or marked as N/A.
Documentation Applicants must attach a copy of their Permanent Change of Station (PCS) orders or indicate if they have previously submitted them.
Certification of Accuracy By signing the form, applicants certify that the information provided is accurate and agree to notify their insurer of any changes.
Consequences of False Information Providing false, fraudulent, or misleading information may lead to civil and criminal penalties under LSA-R.S. 22:1924 and other applicable laws.
Contact Information For questions regarding the form, applicants can contact their insurance agent or the Louisiana Department of Insurance at (800) 259-5300 or (225) 342-5900.
Signature Requirement The form must be signed by the active military personnel to validate the application for the military discount.
Governing Laws This form is governed by LSA-R.S. 22:1482 and Regulation 81, which outline the eligibility and requirements for military discounts in Louisiana.

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Detailed Steps for Writing Louisiana Military Discount

Completing the Louisiana Military Discount form is a straightforward process. This form requires specific information about the active military personnel and their family members. After filling out the form, you will submit it to your insurance company to apply for the military discount.

  1. Obtain the Louisiana Military Discount form from your insurance company or the Louisiana Department of Insurance.
  2. Enter the name of your insurance company in the designated field at the top of the form.
  3. Fill in your policy number or application number as required.
  4. Provide your full name as the active military personnel.
  5. Input your date of birth.
  6. Enter your home address.
  7. Fill in your home phone number. If not applicable, check the N/A box.
  8. If applicable, provide your spouse's name. If not, check the N/A box.
  9. Input your spouse's date of birth. If not applicable, check the N/A box.
  10. List the full names and dates of birth of any licensed dependents. If not applicable, check the N/A box.
  11. Attach a copy of your Permanent Change of Station (PCS) Orders or indicate if they were previously submitted.
  12. Read the certification statement carefully and ensure you meet the criteria for active military personnel.
  13. Sign the form as the active military personnel.
  14. Print your name in the designated area.

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Misconceptions

Here are seven common misconceptions about the Louisiana Military Discount form:

  1. Only active-duty military can apply. Many believe that only active-duty personnel are eligible. However, spouses and dependents can also qualify for the discount.
  2. All sections must be filled out. Some think every section is mandatory. If certain sections do not apply, you can simply check the N/A box next to those fields.
  3. You don’t need to submit proof of service. It's a misconception that proof is unnecessary. You must attach a copy of your Permanent Change of Station (PCS) orders or indicate that they have been submitted previously.
  4. The form can be signed by anyone. Some people assume that anyone can sign the form. Only the active military personnel themselves should sign to certify the information provided is accurate.
  5. Submitting false information is harmless. Many think that providing incorrect information is not a big deal. In reality, it can lead to civil and criminal penalties, including fines.
  6. There’s no deadline for submission. Some believe they can submit the form anytime. However, there may be specific deadlines related to your insurance policy renewal or other time-sensitive matters.
  7. Discounts are automatic once the form is submitted. It is a common belief that the discount will be applied immediately. In fact, you should confirm with your insurance provider to ensure the discount has been applied correctly.

Documents used along the form

When applying for the Louisiana Military Discount, several additional forms and documents may be required to support your application. These documents help verify your eligibility and provide necessary information to your insurance provider. Here’s a brief overview of some of the key forms you might encounter.

  • Proof of Active Duty Status: This document typically includes your military ID or orders that confirm your active duty status. It’s essential for establishing eligibility for the discount.
  • Permanent Change of Station (PCS) Orders: These orders indicate your assignment to a new location. They are crucial for proving that you are stationed in Louisiana and qualify for the military discount.
  • Hold Harmless Agreement: To safeguard your interests, consider the essential Hold Harmless Agreement template for clear liability management.
  • Dependent Verification Documents: If you’re claiming dependents, you may need to provide birth certificates or other legal documents to verify their relationship to you.
  • Insurance Policy Information: A copy of your current insurance policy is often required. This helps the insurer confirm your coverage and apply the discount appropriately.
  • Application for Insurance: If you’re switching providers or applying for a new policy, this application will need to be filled out. It details your coverage needs and personal information.
  • Affidavit of Eligibility: This sworn statement may be required to confirm your eligibility for the military discount. It serves as a formal declaration of your active duty status and residency.
  • Contact Information for Your Insurance Agent: Having your agent’s contact details handy can streamline communication and clarify any questions that arise during the application process.

Gathering these documents ahead of time can simplify the process and ensure that your application for the Louisiana Military Discount goes smoothly. Being prepared not only saves time but also helps avoid any potential delays in receiving your benefits.