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Below
is a list of frequently used forms within our office. These forms can be printed, signed by our client and returned to our office to complete a transaction.

Commercial Forms

Workers’ Compensation Assigned Risk Application
Workers’ Compensation ERM Form
Workers’ Compensation Form 101
Workers’ Compensation Exclude Executive Officers
Construction Classification Credit Application

Surplus Lines Affidavit – Standard Form

Contractor Supplemental Application

Homebuilders Coverage Questionnaire

Group Health Insurance Census


Personal Forms

Commerce Insurance - Operator Exclusion Form
Commerce Insurance - Low Mileage Form
Commerce Insurance - Auto Anti-Theft Credit Form
Commerce Insurance - EFT Form
Safety Insurance - EFT Form
Standard Operator Exclusion Form
Standard Low Mileage Credit Form
Standard Auto Anti-Theft Credit Form
Standard EFT Form

Home Replacement Cost Estimator


Registry of Motor Vehicles Forms
Massachusetts Auto Accident Form
RMV – Family Transfer Form
RMV – Gift Form
RMV – Vehicle Purchased out of State Form
RMV – Duplicate Title Application

© 1998-2007 Herlihy Insurance Group          51 Pullman Street          Worcester, MA          01606          1.888.756.5159          info@herlihygroup.com