Homeowner’s Insurance *Full name of insured *Date of birth *Occupation *Email *Phone number in the USA *Do you have a partner? NoYes If yes, please inform: Full name Date of birth Occupation Phone number *Street address of the property being insured apt number *City *ZIP *Is the title for this property under a business name or your own name? PersonalBusiness Name of business (if applicable) *Is the property paid in full or financed? Paid in fullFinanced *Type of use of the property Primary residenceSecondary residenceRented on a yearlong contractFor rent/Rented on short term agreementNot occupied *Has the property undergone any improvements or renovation? YesNo If yes, in what year? If a house, has it had its roof repaired or replaced? YesNo If so, in what year? *Closed community? YesNo If so, does it have a gate or attendant? AttendantGate *Does the property have a fire alarm? YesNo If yes, is it monitored? YesNo *Does it have a home security system? YesNo If yes, is it monitored? YesNo Does it have a fire sprinkler system? YesNo If a house, does it have a pool? YesNo If yes, is it enclosed by a screen? YesNo *Do you have pets? YesNo If yes, please inform type *Do you currently have an active insurance policy for this property? YesNo, this is a new acquisitionNo, the property is currently not covered Policy effective date Any other relevant information that was not mentioned above?
