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Quote Information needed for Home-Rental

The fastest way to receive a home/rental
quote is to send a copy of your
insurance declaration page

If you have the time, please send the
completed information outlined below

Please include your email address
on any correspondence.

Please call if you have any
questions 972-881-5028 or 214-536-5540

(If the machine answers, please leave a message.)

**The homeowner questionnaire has 7 Sections

Section 1 is your Personal Information
  1. Your Name
  2. Your Date of Birth
  3. Your Social Security Number
  4. Your Home Phone / Cell Phone
  5. Your Street Address
  6. Your City, State, Zip Code
  7. Your County
Section 2 is your Home or Apartment Information
  1. Year Home / Apartment was built
  2. Number of Liveable Square Feet
  3. Type of Construction
  4. Roof Type
  5. Age of Roof
  6. Is your home or apartment inside the city limits?
  7. How many miles from the Fire Station?
  8. How many feet to a Fire Hydrant?
  9. How many stories is your home?
  10. How many bathrooms in your home?
  11. Do you have a fireplace?
  12. Do you have gas heat?
  13. Do you have electric heat?
  14. Do you have central air conditioning?
  15. Do you have a garage?
  16. Is your garage attached?
  17. How many cars does your garage hold?
  18. What type of foundation is your home?
Section 3 is your Eligibility Information
  1. Do you have a swimming pool?
  2. Do you have a diving board with your swimming pool?
  3. Do you have a slide with your swimming pool?
  4. Do you have a fence around your swimming pool?
  5. Do you have a trampoline?
  6. Do you have any animals on property?
  7. If you have a dog, what is the breed?
  8. Do you have any prior bite claims?
  9. Do you have any hoofed or saddle animals?
  10. If yes, what type.
  11. Do you have more than 5 acres?
  12. Do you have any ATVs?
Section 4 is your Claims Information 
  1. Have you had any claims in the past 5 years?
Section 5 is your Security Information
  1. Do you have a monitored fire/burglary alarm system?
  2. When does your monitoring contract expire?
  3. Do you have a dead bolt?
  4. Do you have a Fire Extinguisher?
Section 6 is your Current Coverage Information
  1. What is your current Dwelling (home) value in $?
  2. What is your current percentage of dwelling coverage?
  3. What is your current liability coverage?
  4. What is your current medical coverage?
  5. What is your current deductible percentage?
  6. Do you need additional jewelry value?
  7. Do you have any special replacement items?
Section 7 is your Payor Information
  1. When does your current insurance expire?
  2. What is the name of your current insurance company?
  3. Do you have a mortgage payment?
  4. Is your insurance included in your mortgage payment?

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