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Homeowners Insurance Policy Review
Casey
2026-04-28T22:41:00-07:00
Name
This field is for validation purposes and should be left unchanged.
Homeowners Renewal Questionnaire
Please review and update your information prior to your policy renewal to ensure your coverage remains accurate and current.
Please Confirm Your First and Last Name
(Required)
First
Last
Please Confirm Your Property Address
(Required)
Please Confirm Your Email Address
(Required)
Please Confirm Your Phone Number
Has the property been remodeled or renovated?
(Required)
Yes
No
Please describe the renovation
(Required)
Has Your Roof Been Updated?
Yes
No
Year roof was replaced:
Please enter a number from
1970
to
2026
.
Has a swimming pool, trampoline, or other recreational structure been added?
(Required)
Yes
No
Type of structure added
Has a business been operated from the home this policy period?
(Required)
Yes
No
How is the property primarily used?
(Required)
Primary residence
Secondary / vacation home
Rental property
Vacant
How many occupants reside in your residence?
1 (only me)
2
3
4
5+
Do you have any renters or tenants?
(Required)
Yes
No
(This includes VRBO, AirBnb or any other short term rental)
Which of the following are currently installed? (select all that apply)
Smoke detectors
Carbon monoxide detectors
Fire sprinkler system
Burglar alarm
Central monitoring
Deadbolt locks
Security cameras
Smart home system
Are there high-value items to schedule separately? (jewelry, art, electronics)
Yes
No
List items and estimated values
Additional comments or coverage questions
Authorization & Certification
(Required)
I confirm the above information is accurate and I authorize my agent to update my policy accordingly.
By submitting this form, I certify that the information provided is accurate and complete to the best of my knowledge. I understand that any material misrepresentation may affect my coverage.
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