Personal Lines Fact Finder

Step 1 of 7

Homeowners Info
Current Home Carrier
How Much Coverage?
Current Property Deductible
Paying how much?
Has it canceled in the past 30 days?
Any Claims?
Type of claim; date of claim; & claim amount
Is the location address different than the mailing address?
Location Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Miles from the Fire Department
Is there a fire hydrant within 1000 ft of the house?
Are there smoke detectors in every room?
Are smoke detectors hardwired or battery powered?
Is there an alarm system?
Property type
- Apartment
- House
- Mobile Home
Any pets? (Need Breeds of any Dogs)
Any buildings used for business?
Personal Property Coverage Amount
Notes

Date of Purchase
MM slash DD slash YYYY
Purchase Price (If purchase within the past 2 years)
Is there a mortgage?
Who is the mortgage with?
Current person(s) name on deed?
Property Info
Year Home was Built
Style of home
Number of Stories
Total Sq ft
Frame or Masonry
Number of acres
Is Mobile Home on Slab?
Dimensions of Mobile Home
Number of Families
Basement
Is there a sump pump?
Type of Basement
Percent of Basement That is Finished
Roof Material
Roof Type (Shape)
Siding Type
Do you have a garage?
Is garage attached or detached?
Number of Cars (Garage size)
Att porch/ deck/ carport/ breezeway? If so details?
Any other outbuildings (Barns, Sheds, ect.)? If so details (type, size, ect.)
Number of Full Baths
Number of Half Baths
Heat Type
Is there a Wood stove/ Pellet stove/ or Fireplace? If yes what & how many?
When was the heat last updated?
When was the plumbing last updated?
When was the electric last updated?
When was the roof last updated?
Underwriting
Is there a swimming pool?
Is it fenced with a locked gate?
Is there a hottub?
Is it fenced with a locked gate?
Do you operate a daycare or any other business out of your home?
Do you do any farming?
Do you rent your home to others? (Airbnb, VEMO, Ect)
Do you own any other property?
Do you own any valuable items? (Jewlery, Guns, Antiques, Art, ect.)
Notes

How many drivers will there be?
Driver 1
Name
First Middle Last
Date of Birth
MM slash DD slash YYYY
License Number
Marital Status
Year Licensed
Any accidents, tickets, or suspensions?
Has driver completed boating safety course?
Driver 2
Name
First Middle Last
Date of Birth
MM slash DD slash YYYY
License Number
Marital Status
Year Licensed
Any accidents, tickets, or suspensions?
Has driver completed boating safety course?
Driver 3
Name
First Middle Last
Date of Birth
MM slash DD slash YYYY
License Number
Marital Status
Year Licensed
Any accidents, tickets, or suspensions?
Has driver completed boating safety course?
Boat Info
How many boats do you need to insure?
Boat 1
Boat Type
Year, Make, & Model
HIN Number
New or Used
Purchase Year
Purchase Price
Cost New
Hull Material
Propulsion Type
Motor Serial Number
Motor Value
Max Speed
Any Accessories? (Depth Finder, Fishing Gear, ect)
Comp Deductible
Collision Deductible
What vehicle will be transporting boat?
Where will boat be stored?
Will there be trailer coverage?
Boat 2
Boat Type
Year, Make, & Model
HIN Number
New or Used
Purchase Year
Purchase Price
Cost New
Hull Material
Propulsion Type
Motor Serial Number
Motor Value
Max Speed
Any Accessories? (Depth Finder, Fishing Gear, ect)
Comp Deductible
Collision Deductible
Where will boat be stored?
Boat 3
Boat Type
Year, Make, & Model
HIN Number
New or Used
Purchase Year
Purchase Price
Cost New
Hull Material
Propulsion Type
Motor Serial Number
Motor Value
Max Speed
Any Accessories? (Depth Finder, Fishing Gear, ect)
Comp Deductible
Collision Deductible
Where will boat be stored?
Trailer 1
New or Used
Purchase Date
Purchase Price
Price New
Year, Make, & Model
VIN
Comp Deductible
Collision Deductible
Trailer 2
New or Used
Purchase Date
Purchase Price
Price New
Year, Make, & Model
VIN
Comp Deductible
Collision Deductible
Notes

How many drivers will there be?
Driver 1
Name
First Middle Last
Date of Birth
MM slash DD slash YYYY
License Number
Marital Status
Any accidents, tickets, or suspensions?
Approved Safety Course Completion (Documentation Req)
Years Riding Experience
How Often Do You Ride?
Are you a member of a motorcycle club? (Proof Required)
Driver 2
Name
First Middle Last
Date of Birth
MM slash DD slash YYYY
License Number
Marital Status
Any accidents, tickets, or suspensions?
Approved Safety Course Completion (Documentation Req)
Years Riding Experience
How Often Do You Ride?
Are you a member of a motorcycle club? (Proof Required)
Vehicle Info
Policy Type
How Many Vehicles Will There Be
Vehicle 1
Vehicle Type
Year, Make, & Model
CC-Size
VIN
Anti-Lock Brakes
Turbo or Nitrous Oxide Kit
Modified Frame
Off-Road Use
Comp Deductible
Collision Deductible
Liability Coverage
Liability Coverage (Policy Level)
Trip Interruption, Carried Contents, or Accessory Coverage?
Vehicle 2
Vehicle Type
Year, Make, & Model
CC-Size
VIN
Anti-Lock Brakes
Turbo or Nitrous Oxide Kit
Modified Frame
Off-Road Use
Comp Deductible
Collision Deductible
Trip Interruption, Carried Contents, or Accessory Coverage?
Vehicle 3
Vehicle Type
Year, Make, & Model
CC-Size
VIN
Anti-Lock Brakes
Turbo or Nitrous Oxide Kit
Modified Frame
Off-Road Use
Comp Deductible
Collision Deductible
Trip Interruption, Carried Contents, or Accessory Coverage?
Notes

Personal Lines Fact Finder

Personal Lines Fact Finder

Step 1 of 7

Auto Driver Info

Driver 1

Driver 2

Driver 3

Driver 4

Driver 5

Vehicle Info

Vehicle 1

Vehicle 2

Vehicle 3

Vehicle 4

Vehicle 5

Homeowners Info

Property Info

Underwriting

Driver 1

Driver 2

Driver 3

Boat Info

Boat 1

Boat 2

Boat 3

Trailer 1

Trailer 2

Driver 1

Driver 2

Vehicle Info

Vehicle 1

Vehicle 2

Vehicle 3

Personal Lines Fact Finder

Step 1 of 7

Auto Driver Info

Driver 1

Driver 2

Driver 3

Driver 4

Driver 5

Vehicle Info

Vehicle 1

Vehicle 2

Vehicle 3

Vehicle 4

Vehicle 5

Homeowners Info

Property Info

Underwriting

Driver 1

Driver 2

Driver 3

Boat Info

Boat 1

Boat 2

Boat 3

Trailer 1

Trailer 2

Driver 1

Driver 2

Vehicle Info

Vehicle 1

Vehicle 2

Vehicle 3

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