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Type of Home:—Please choose an option—Single FamilyTownhouseVillaCondoDuplexMobile/ManufacturedTiny Home
Current Insurance Carrier:
Have you had any claims?YesNo
Which type of claim?—Please choose an option—HurricaneWater DamageFireHailTheftOther
What year?—Please choose an option—20202019201820172016201520142013201220112010
Occupancy:I live in the homeI rent out the home
Occupancy period:Full TimePart Time
# of Months per Year:—Please choose an option—123456789101112
Select the Minimum lease period you rent your home for: —Please choose an option—1 year lease6 month leasesmonth to monthweeklydaily
Number of Stories: —Please choose an option—123More than 3
Construction type: —Please choose an option—Wood FrameConcrete Block
Roof Type: —Please choose an option—TileMetalShingle
Screened Porches or Patios: —Please choose an option—1234
Have you had a Wind Mitigation Inspection?YesNo
Does the property have a swimming pool?YesNo
Any Pets or Animals?YesNo
Policies Needed (Check all that apply): General LiabilityPropertyBusiness InterruptionErrors & OmissionsWorkers CompCommercial AutoOther