2024 AO Umbrella Renewal Questionnaire Basic

Umbrella Renewal Questionnaire
If you start to fill out this form and realize you dont have all the info, just keep going and select the option at the end that says "not finished yet" and hit "submit". That way, you'll get an email with a link so you can edit and re-submit your form when you're finished.
Your Name*

First NameLast Name
Your Occupation*
Spouse Name*

First NameLast Name
Your Occupation*
Approximate total household income*
So we can help give guidance on limits of liability, etc.
Approximate total household net worth (everything you own, minus what you owe is net worth)*
So we can help give guidance on limits of liability, etc.
If you would like a quote on higher liability limits than you have now, please indicate the limits you'd like quotes for below (select all that apply):

$2,000,000 & $3,000,0004,000,000 & $5,000,000$5,000,000+Help me figure out what is appropriate
Primary Residence Address:*
Physical home address
Secondary Residence Address(es):
If none, leave blank or put "none"

Please list ALL household members (including you, spouse, children including those away at school, relatives, roommates or anyone who lives or has their permanent address as your house)*
Please List all accidents or traffic violations in last 5 years (skip if none)
Please input below the number of each type of vehicle owned, leased, or regularly used by the you, spouse, wards, and resident relatives (licensed for road use):
Number of Automobiles *
Year Make Model of all automobiles*
Number of Motorcycles*
Are any of the Motorcycles licensed or registered for road use ?*
Number of Mopeds*
Are any of the Mopeds licensed or registered for road use?*
Number of Golfcarts*
Are any of the Golfcarts licensed or registered for road use?*
Number of Motorhomes*
Number of Antique/Classic limited use Automobiles *
Have you had any liability claims paid or pending in the last five (5) years?*
Have you had any liability claims paid or pending in the last five (5) years?*
Please describe the claim or lawsuit:
Do you, your spouse, or any household member have regular use of any vehicles which you do not own? *
in other words, do you have any other vehicles insured elsewhere?
Please list the year/make/model of all NON-owned vehicles that you have regular use of and indicate WHO they are owned & insured by*
This would be a company provided take home vehicle for example
Do you, your spouse, or any household member: own or co-own any other automobiles NOT insured on your Florida Auto Owners insurance policy? *
in other words, do you have any other vehicles insured elsewhere?
Please describe the vehicle (year/make/model); who drives it; who owns it; where it is usually garaged; and what insurance company provides the insurance:*
Do you have any Recreational Vehicles (ATV, Dune Buggy, UTV/Side-by-side, that a not licensed for road use?*
Number Snowmobiles*
Number of Dune Buggies*
Number of Mini Bikes*
Number of Trail Bikes*
Number of Other Off Road Vehicles (UTV/side-by-side/ATV/etc)*
Do you own/co-own/lease, etc anything else with a motor and wheels (besides a lawn mower):*
Please describe what vehicle you own that we haven't yet listed*
Do you have any boats/jet skis/or other watercraft of any kind?*
Please list details below for ALL watercraft*
For your watercraft, is there any:*

Business UsePaid Captain & Crew
What bodies of water do you take the boat in? (include specifics if you ever go more than 75 miles off the US Coast)*
Ex: Leon County Lakes & the Gulf of Mexico
Do you, your spouse, or any household member:*

Own, Lease, or Charter any aircraftHave a pilots licenseRequire aircraft coverage under your umbrella liability policy?NO, none of the above
Do you have any home business? (other than a home office)*
Home daycare, tennis or piano lessons, salon, etc
Please describe your home business*
We'll ask for more details when we talk, just give us the basics
Do you own any residential rental properties*
Are any residential rental properties owned by an LLC/Trust or by anyone other than you and/or your spouse?*
For all residential rental properties, please list: Deeded Owner; Address; # of units you own in that dwelling (if it's a duplex and you own both sides, answer is 2 - if you own one side, answer is 1) *
Please list addresses for all rental properties*
Do you own any commercial (non-residential) rental properties*
List address, occupancy, number of stories, and sq. ft. per building:*
Do you co-own any property with anyone else not living in your household?*
Ex: do you own a rental or secondary residence with multiple other family members or friends?
Please provide their name, mailing address, and describe your and their interest in the property (property address, ownership percentage, usage, etc)*
Do you or anyone in the household contemplate entering races, contests, or exhibitions?*
If there are any questions you have, or any clarifications you think are important/relevant, please let us know here.
Do you or anyone in the household have any pets?*
Tell us what kind and number pets you have (3 dogs, 2 cats, 2 horses, etc). If you have any dogs, please list ALL breeds they are mixed with. If you have dogs, please lets us know if any have a bite history or any Police/Attack/Military training.*

(almost done!) These last questions help us prepare the application which allows Auto Owners to continue to provide you the broadest coverage available. We will have some of these answers, but making sure we ask them again is important to making SURE we get it right for you.
What year was your primary residence built?*
Best guess is actually fine on this one
Can your house be seen by 2 other occupied dwellings?*
Do you have a pool?
Is it fenced or screened or otherwise secured?
Any business, day care or farming on premises?*
Any flooding/brush/landslide or unusual hazards?*
Has any company canceled, refused to write or declined renewal for you?*
Has this applicant filed personal bankruptcy, had repossessions, court judgments or substantially past due mortgage, utility or property tax payments within the past 5 years?*
Is dwelling within 2 miles of a salt water body?*
Has any applicant been convicted of arson?*
Any uncorrected fire code violations?*
Is building undergoing renovation or reconstruction?*
Is dwelling for sale?*
Do you have any outbuildings*
Describe outbuilding and use:
Is the dwelling inaccessible by fire or police or is it not within view of other occupied dwellings?*
Is this residence used as a boarding or lodging house or for student rentals?*
To your knowledge, does the dwelling location have, or has it ever had, sinkhole activity or ground movement on premises?*
Are you 100% finished or do you need to revise after you have more information?*
What are you missing?
.... so you can remember later :)
Thank you for taking your valuable time to complete this renewal questoinnaire. This will allow us to review your file, complete the renewal paperwork, and send it to you for your review and signature so we may continue helping you with your Personal Umbrella Liability protection.
Please verify that you are human*
Should be Empty: