• Homeowners/Condo/Dwelling Insurance Questionnaire

    Complete this questionnaire for Anchor Insurance Agency. Provide the home, occupancy, coverage, and claim information requested to avoid delay in quote.
  • Upload a File
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  • Applicant Information

  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Is the mailing address the same as property address?*

  • Property Details

  • Purchase & Mortgage Information

  • New Purchase*
  • Date of Purchase*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Occupancy Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is there a mortgage on the property?*
  • Insurance Escrowed*

  • Rental / Short-Term Rental Use

    We do not have a market for less than weekly rentals. If this is a rental property, all quotes provided only cover weekly or more rentals.
  • Is this a rental?*
  • Is this rented less than weekly?

  • System Updates

    Update years must be provided in order to receive a quote.

  • Exterior & Structure Details

  • Fenced w/ Locking Gate*
  • Trampoline*

  • Safety & Interior Features

  • Hydrant < 1,000 ft*
  • Fire Dept < 5 miles*

  • Pets & Liability

  • Do you have any pets?*
  • Bite History

  • Condo / Association Details

  • Master Policy Coverage Type
  • Unit Owner's Wall Coverage Responsibility
  • Association Policy – Interior Coverage Confirmation
  • Condo Docs / Bylaws on File?

  • Planned Renovations

  • Prior Insurance & Claims

  • Any claims in the last 5 years?*
  • Do you need a quote for Flood Insurance?*
  • Upload Elevation Certificate
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  • Acknowledgment & Signature

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: