Occupants on the TitleFull Name: First Name Last Name DOB: Date Occupation: How long with current employer: Full Name: First Name Last Name DOB: Date Occupation: How long with current employer: Current Home Address:Street Address Address Line 2 City Province Postal CodeNew Home Address (if applicable):Street Address Address Line 2 City Province Postal Code Purchase Date: Date Closing Date: Date First time home buyer? Yes No
Mortgage InformationCompany: Type a label Address: Street Address Address Line 2 City Province Postal Code
Prior address if moved in the last 3 yearsStreet Address Address Line 2 City Province Postal Code Length at this location: Date you have been continuously insured for property insurance: Date
Current Insurance Provider InformationName of Company: Policy Number: Expiry Date: Date Length of Time with:
Property DetailsTotal property acres if greater than 1 acre: Use of land if greater than 1 acre:
Provide the Year the Dwelling was Built: Structure Type (example: detached semi, bi-level, row, etc.): Exterior siding (example: solid brick, vinyl, veneer, etc.) * Heating Type: * Year Last Updated: * Heating type - if oil, please provide all details regarding the tank (put in N/A if not applicable)*
Wood burning stove? Yes No If Yes: Insert Stand alone N/A (not applicable)* Last WETT Inspected (write n/a if not applicable):
PlumbingType: * Year last updated: * Galvanize plumbing % (if applicable): *
RoofRoof covering: * Year last done: *
ElectricalType: * Number of Amps: * Panel Type Fuses/Breakers: * Year Last Updated: *
Water Prevention Water prevention in basement? Yes No* If Yes:Is it alarmed? Yes No N/A* Does it have backup power? Yes No N/A*
Hot Water HeaterType: * Year: * Fuel: *
Square Footage (excluding basement unless home is a split-level):* Number of Stories:* Number of Families:* Basement Square Footage: * % of Finished * Walk-Out Basement?: Yes No* Central or local monitored fire/burglar alarms: Yes No* If Yes, provide Company Name: *
Number of Smoke Detectors: * Number of Fire Extinguishers: * Distance to closest Fire Hydrant: * Distance to closest Fire Hall: *
Garage Garage Type: Attached Detached* Number of Cars: * Year Built: * Exterior Siding: * Number of Door Openers: *
Decks, Porches, BalconiesSquare Footage of Decks: * Year Built: * Type: Wood Synthetic* Square Footage of Porches: * Year Built: * Type: * Square Footage of Balconies: * Year Built: *
Rooms and BathsNumber of Bedrooms: * Total Number of Rooms: * Number of Full Baths: * Number of Half Baths: *
Pool Hot Tub* Type: * Year Built: *
Type: * Year Built: * Value: *
Central AirYes No* If yes, does it use the same air ducts? *