"*" indicates required fields 12345 LinkedInThis 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* About You Just the basics for now. Name First Last PhoneDate of Birth Email Is there a Co-applicant? Yes No Co-applicant's Name First Last Co-applicants Date of Birth 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 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 Above
