Abridged Homeowners Insurance Questionnaire Abridged Homeowners Insurance Questionnaire Thomas Insurance Advisors Homeowners Insurance Checklist last edited 03.20.2018 -- simplified as short form (abridged) Step 1 of 5 20% General InformationName:* First Last Phone Number:*If you have dog(s), what breed(s)?*Mark "N/A" if this does not apply. Your HomeCurrent Market Value of your home (An estimate is fine):*Is there a basement?*YesNoIf you do have a basement, is it a walk out?*YesNoN/AWhat percentage of the basement is finished?*Mark N/A if you do not have a basement.CoveragePlease upload your most current insurance policy coverage declarations pages in PDF format so we can see the exact coverage limits you'd like us to compare. These can be easily downloaded from your online profile with your current provider (if you have a login), or from your current agentAccepted file types: jpg, pdf. Exterior of the HomeWhat percentage is 'siding'?*Siding or wall cladding is the protective material attached to the exterior side of a wall of a house or other building.What percentage is 'brick'?*Last year roof was updated:*Do you have a swimming pool at your home?*YesNo Interior of the HomeWhat kind of alarm system do you have in your home?*Mark "N/A" if this does not apply.How many fireplaces do you have?*N/A123Are there circuit breakers?*YesNoKnob & tube/aluminum wiring?*YesNoOther Items to be coveredDo you need earthquake coverage?*YesNoI don't knowDo you need jewelry coverage?*YesNoIf you do need jewelry coverage, how much ($) is needed?*Mark "N/A" if this does not apply. Thank you for your time!Thomas Insurance Advisors would like to thank you for completing the homeowners questionnaire. If you have additional questions, concerns or feel you need to supply additional information; then please use the space below.
