"*" indicates required fields 12345 X/TwitterThis field is for validation purposes and should be left unchanged. Let's Get Started First up, what property would you like insured? Address you want to insure* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Do you currently live here* Yes No Date you'd like the policy to begin* MM slash DD slash YYYY About You Just the basics for now. Name First Last PhoneDate of Birth MM slash DD slash YYYY Email Is there a Co-applicant? Yes No Co-applicant's Name First Last Co-applicants Date of Birth MM slash DD slash YYYY Co-applicant's Email About Your Condo Let's learn about your property. Year BuiltSquare FootageNumber of Stories in your Condo Unit1 Story1.5 Story2 Story2.5 Story3 StoryBelow GradeBi- LevelTri-LevelNumber of Units in Your Building1 Unit2 Units3 Units4 Units5 or MoreRoof MaterialArchitectural ShinglesAsphalt/Fiberglass ShinglesBuilt-up Tar and GravelClay TileConcrete TileHail Proof (Impact Resistant)Mission TileSlateTinWood Shakes/ShinglesUnsureFoundation TypeSlab at Grade (Most Common in Florida)Crawl SpaceBasement UnfinishedPiersSuspended Over HillsideBasement Partially FinishedBasement FinishedUnsure Property Details We need a few more details on your home. Home Purchase Date MM slash DD slash YYYY How is this home occupied Primary residence Seasonal residence Vacant Long-Term rental Estimated Value of Your Personal Property $15,000 (Minimum) $25,000 (Average) $35,000 Other Help Me Estimate Is this residence rented out for any portion of the year? Yes No How many people are living in your Condo?Do you have a mortgage or loan on this property? Yes No Do you share your home with any of the following? Partner, Kids, Dogs, Cats Yes No Finishing Touches A few more questions. Marital StatusSingleMarriedDivorced or SeparatedWidowedEmployment StatusEmployedUnemployedSelf-employedHighest Level of EducationSome high schoolHigh school graduate, diploma or the equivalentSome collegeAssociate degreeTechnical or occupational certificateBachelor’s degreeMaster’s degreeDoctorateProfessionalNone of the AboveCAPTCHA
