Electronic Data Interchange Survey

Dear Lender or Lending Servicer,

State Farm Insurance can send their notices electronically using the X12 national standard. This format has been accepted throughout the insurance and mortgage industries and is endorsed by the Mortgage Bankers Association. In order to receive our electronic hazard renewal in the X12 format, please fill in the appropriate information below and email to:

To complete the form, follow these steps:

  • Click the link to view the EDI Survey PDF in your browser
  • Download or Save the PDF to your electronic device or computer
  • Open the saved PDF using Adobe Acrobat and enter the request information
  • Re-save the PDF and then attach it to an email to the above address

EDI Survey Form PDF