NAME*
STREET ADDRESS*
CITY*
STATE*
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HOW DO YOU PREFER TO BE CONTACTED? PHONEEMAIL
What is the residence type?
HOMEMULTI FAMILY HOMECONDOCO-OPRENTAL
MARKET VALUE
SQUARE FOOTAGE
YEAR BUILT OF HOME
IS THE LOCATION YOU ARE LOOKING TO INSURE A NEW PURCHASE OR A PROPERTY YOU ALREADY OWN?
Is the home a colonial, split level, ranch, cape cod, contemporary, or other?
Is the construction type frame, masonry, fire-restrictive, stucco or masonry veneer?
Is there a basement? If yes, is it finished or unfinished
Number of bathrooms
Was the home renovated, and if yes when?
Will the home be under renovation/construction? If yes, provide details
Are there any other structures on the property such as a detached garage, pool, tennis court, guest house, barn? Please list.
Is there a central station fire and burglar alarm?
List any other security features that might provide an additional discount, such as a water flow alarm, automatic backup generator?
Is there an underground oil tank?
Current homeowners insurance carrier
Current homeowners insurance premium
MULTI FAMILY HOME
CONDO
CO-OP
RENTAL APARTMENT
