Homeowners

Homeowners Insurance Questionnaire

Property is occupied by:  Owner Tenant Both owner and tenant
If owned and/or tenant occupied, how many families?  1 2 3 4
Provide details on any remodel, renovations, upgrades that have been completed to:

Any claims in the last 5 years?  Yes No If yes provide details:

 1 2 3
 1 2 3 4

Type of framing:  wood block metal other
Type of exterior siding:  brick wood vinyl stucco fiber cement other
Type of foundation:  slab piers pilings
Type of roof:  metal asphalt shingles tile flat
Please indicate yes or no and quantity or size, if applicable:

 Yes No
 Yes No
 Yes No  1 2 3 car(s)
 Yes No Size:
 Yes No Size:
 Yes No
 Yes No
 Yes No enclosed? Yes No

Primary Heating?  gas electric other
Do you want to finance your policy?  Yes No