Is there a Co-applicant? If so, please provide name, date of birth, and occupation
Is this home a new purchase? *
Contruction type *
Number of Floors including basement *
Any steps going up to your front door? *
Is there a railing? *
What type of siding does your home have? *
Do you have a swimming pool? *
If yes, is the pool above ground or in ground?
Is the backyard fenced with a self-locking gate? *
What type of heat does the house have? *
If oil heat, where is the oil tank located?
Is any portion of the roof flat? *
When was the last time the roof was redone? *
When was the last update for the heating system? *
When was the last update for the electric? *
When was the last time the plumbing was upgraded? *
What type of basement do you have? *
Do you currently have insurance? *
Deductible Amount *
Do you have a garage? *
Do you own a boat? *
Do you carry flood insurance?
Do you have a sump pump in your basement?
Is there a trampoline on the premises? *
Do you have a deck? *
Is there a woodburning stove in the house? *
Mortgage name address & loan number
Who pays the premium? You or mortgage?
Do you have Life Insurance? *