Coverage description
An Insurance Services Office (ISO) standard form. It lists persons or organizations, beyond any mortgagee, that have an interest in the residence premises, and requires the insurer to notify them in writing if it cancels or does not renew the policy.
How the form has changed
The 10 00 and 03 22 editions change the schedule layout and form date. The coverage wording is the same.
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed |
|---|---|---|---|---|
| 03 22Mar 2022Latest | 103 | 22 | 43 | Jan 2022 to Oct 2026 |
| 10 00Oct 2000 | 53 | 44 | 28 | Nov 2021 to Sep 2026 |
| 04 91Apr 1991 | 14 | 12 | 10 | Nov 2021 to Sep 2025 |
3 other edition dates appear in one or two filings each, often carrier-specific versions: 01 14, 06 10, 10/01/00.
Where filings record what this form replaced, they name earlier edition 03 22 and other forms H-358, HO 04 16. Only some filings record replacements.
What the filings show
- Edition in use: in the past 12 months, 9 companies filed the 03 22 edition and 5 companies filed 10 00.
- HO 04 41 (Additional Insured - Residence Premises) is filed alongside it most often, in 140 of the same filings (79%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Oct 2026, excluding withdrawn and rejected filings. One filing can cover several affiliated companies.
Carriers filing this form
The 10 carrier groups with the most filings that include HO 04 10, out of 41 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Assurant Incorporated GroupAmerican Bankers Insurance Company of Florida | 34 | 32 | 03 2210 00 | Oct 14, 2026 |
| Armed Forces Insurance Exchange | 33 | 33 | 03 2204 91 | Aug 27, 2026 |
| Hastings Mutual Insurance Company | 10 | 5 | 10 0004 91 | Mar 13, 2025 |
| Insurance Services Office, Inc.Advisory Organization | 9 | 9 | 03 22 | Dec 4, 2024 |
| Westfield GroupOld Guard Insurance Company | 9 | 9 | 10 0010/01/00 | May 29, 2026 |
| Acuity, A Mutual Insurance Company | 8 | 8 | 03 22 | Jul 2, 2026 |
| American Family Insurance Group8 group companies filed it, led by Grain Dealers Mutual Insurance Company and NGM Insurance Company | 8 | 4 | 03 2210 0001 14 | Jun 23, 2025 |
| Encova Mutual Insurance Group4 group companies filed it, led by Motorists Mutual Insurance Company and Iowa Mutual Insurance Company | 7 | 7 | 10 00 | Apr 24, 2023 |
| NEW London Cnty Group3 group companies filed it, led by New London County Mutual Insurance Co. and Danbury Insurance Company | 6 | 3 | 03 2210 00 | Apr 17, 2026 |
| Utica Group2 group companies filed it, led by Founders Insurance Company and Utica Mutual Insurance Company | 6 | 5 | 03 22 | Dec 5, 2023 |
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States
Number of filings that include HO 04 10 in each state, Oct 2021 to Oct 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- HO 04 41Additional Insured - Residence Premises140 filings
- HO 00 03Homeowners 3 - Special Form134 filings
- HO 04 48Other Structures on the Residence Premises - Increased Limits133 filings
- HO 04 40Structures Rented to Others - Residence Premises124 filings
- HO 04 77Ordinance or Law Increased Amount of Coverage120 filings
- HO 04 90Personal Property Replacement Cost Loss Settlement120 filings
- HO 04 35Supplemental Loss Assessment Coverage119 filings
- HO 04 16Premises Alarm, Water Leak Detection or Fire Protection System117 filings
- HO 24 71Designated Business Pursuits Liability Coverage101 filings
- HO 04 65Coverage C Increased Special Limits of Liability96 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Oct 14, 2026 | American Bankers Insurance Company of Florida | MD | 03 22 | ASPX-135123185 |
| Oct 5, 2026 | BrightShore Insurance Company | RI | 03 22 | CUAN-135072480 |
| Sep 14, 2026 | American Modern Select Insurance Company | CA | 10 00 | TRUW-135088756 |
| Aug 27, 2026 | Armed Forces Insurance Exchange | CA | 03 22 | ARMD-134961669 |
| Aug 14, 2026 | Builder Reciprocal Insurance Exchange | NM | 03 22 | BRIE-135052376 |
| Jul 2, 2026 | Acuity, A Mutual Insurance Company | IL | 03 22 | ACUT-134943551 |
| Jun 24, 2026 | Acuity, A Mutual Insurance Company | IN | 03 22 | ACUT-134949931 |
| Jun 10, 2026 | Acuity, A Mutual Insurance Company | AZ | 03 22 | ACUT-134943550 |
| Jun 10, 2026 | Acuity, A Mutual Insurance Company | WI | 03 22 | ACUT-134943553 |
| Jun 9, 2026 | Acuity, A Mutual Insurance Company | IA | 03 22 | ACUT-134943552 |
| Jun 9, 2026 | Acuity, A Mutual Insurance Company | KS | 03 22 | ACUT-134949932 |
| Jun 9, 2026 | Acuity, A Mutual Insurance Company | MO | 03 22 | ACUT-134949934 |
Most filed ISO HO forms
- HO 00 03 Homeowners 3 Special Form
- HO 04 90 Personal Property Replacement Cost Loss Settlement
- HO 04 41 Additional Insured - Residence Premises
- HO 04 48 Other Structures on the Residence Premises - Increased Limits
- HO 04 16 Premises Alarm Water Leak Detection or Fire Protection System
- HO 04 98 Refrigerated Property Coverage
- HO 04 35 Supplemental Loss Assessment Coverage
- HO 04 77 Ordinance or Law Increased Amount of Coverage
- HO 00 06 Homeowners 6 - Unit- Owners Form
- HO 24 13 Incidental Low Power Recreational Motor Vehicle Liability Coverage Endorsement
- HO 04 40 Structures Rented to Others - Residence Premises
- HO 03 12 Windstorm or Hail Percentage Deductible
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