Homeowners

Homeowners Insurance Form Template
Name

First NameLast Name
Date of birth

MonthDayYear
DOB
What’s your home address?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you rent or own it?
Year purchased

MonthDayYear
Date
Are you closing on a new home or just thinking of switching insurers?
What type of property is it?
What type of building is it?
Number of stories
What is the square footage of your home?
Square Footage
Total square footage of outside porch/deck area
Square Footage
Who lives in your home?
How would you describe the condition of the Exterior & Interior?
Type of construction
Type of siding
When was your house built?
How do you heat your home?
Where is the tank located?
Age of boiler
What breed is/are the dog(s)?
Did your home undergo any substantial renovations? If so, when?
*Leave blank if no renovations or unknown
Please describe the type of work that was done
Details about renovations
Do you have any of the following?
If you’d like, we can match our coverage to your existing policy.
Do you want to upload your current policy information or enter it manually?
Upload a copy of your existing policy so we may review and compare

Cancelof
Did you file any home or property claim within the past 5 years?
Should be Empty:

Homeowners Insurance Form Template