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Home Owners

 

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Contact Information

 

Full Name Phone Number
Address   Fax Number
City   Email Address
State   Zip Code

 

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Questions

 

Property Address

City

County
Sub Division
Inside or Outside City Limits

 

Year Built ? Dates of Wiring ?
Dates of Plumbing ? Dates of Heating ?
Age of Roof ? If over 30 years old, any updates to the roof
Roof Condition ? Type of Roof ?
Full Time Resident ?
Swimming Pool ? Central Heat or Air ?
Is the House Fenced ? Wood Burning Stove ?

 

What is the square footage of the house?
How many stories is the house ?
Where is the closest fire hydrant ? in feet
Where is the closest fire department ? in miles

 

 

 

Questions

 

Dwelling Limit (Don't include the land value)
Inside Contents
Liability Limit
Medical Payments
Any rental properties ?
Any losses in past 3 Years ?
What is the outside structure of the house made of?

 

 

 

 

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