Homeowner’s Questionnaire- Sharon

What brought you to our site today?

Purchasing a new homeRefinancing my homeComparing my current policy with a McCabe insurance policyUpdating my current policy

Your Email (required) Your Name (required)

Your Phone Number (Required)

Your Date of Birth (MM/DD/YYYY) (required)

Name and Date of Birth (MM/DD/YYYY) for another person/s appearing on the policy (MM/DD/YYYY)

Name and Date of Birth (MM/DD/YYYY) for another person/s appearing on the policy (MM/DD/YYYY)

Your current address(required)

City, State and Zip (required)

New address if you are moving

City, State and Zip


Building

Style:

Type:

Number of Stories:

Square Footage:

Foundation Type:

Basement :

Basement Type:

Exterior Walls (you may select more than one):

Exterior Walls (if more than one type, please state what percentage of each):

Roof:

Approximate Age of Roof:


Exterior Features

Number of Sliding Glass Doors:

Number of Bay Windows:

Number of Bow Windows:

Number of Atrium Windows:

Number of Picture Windows:

Number of Skylights:


Kitchen & Baths

Kitchen:

Year and description of last upgrade:

Countertops made of:

If other countertop type, please specify here:


Baths:

Number of Full Baths:

Number of Half Baths:

Year and description of last upgrade:


Wall, Ceiling & Floor Finish

Wall Finish:

Percent Paint:

Percent Wallpaper/Vinyl:

Percent Wood Paneling:

Percent Ceramic Tile:

Percent Mirrors:

Percent Stone:

Percent Other:


Ceiling Finish:

Recessed Lighting (percentage or number):


Floor Finish:

Percent Carpet:

Percent Hardwood:

Percent Laminate:

Percent Ceramic Tile:

Percent Vinyl:


Heating and Cooling

Heating:

Heat Source/Fuel:

Numer of Heat Pumps:

Approximate Age of Heating/Cooling:


Cooling:

Number of Central AC Units:

Number of Window Units:


Interior Features

Security:

Central Burglar Alarm: YesNo

Central Fire Alarm: YesNo

Interior Sprinklers: YesNo

Central Stereo System: YesNo

Central Vacuum System: YesNo

Intercom System: YesNo


Fireplaces & Wood Stoves:

Number of Wood Burning Fireplaces:

Number of Gas Fireplaces:

Number of Free Standing Wood Burning Stoves:

Number of Pellet Stoves:


Other Interior Items

Finished Attic (number of sq. ft.):

Number of French Doors:

Number of Hot Tubs:

Number of Jacuzzis:

Number of Wetbars:

Number of Saunas:


Garages & Carports

Garage:

Number of Cars:

Carport:


Attached Structures

Wood Deck: YesNo

Deck Made of:

Approximate Sq. Ft.:

Open Porch: YesNo

Approximate Sq. Ft.:

Enclosed Porch: YesNo

Approximate Sq. Ft.:


Detached Outside Structures

Number of Hot Tub/Jacuzzi:

Number of Sheds and Size of Each (S, M, L):

Swimming Pool (Underground): YesNo

Approximate number of gallons:

Swimming Pool (Above ground): YesNo

Approximate number of gallons:


CURRENT INSURER:

CLAIMS HISTORY:

Any claims been reported in the last 3 years? If so, date of claim and brief description.

How long have you been at this address?:

If less than 3 years please list prior address:

Current Homeowners Deductible ($):

Please list any additional coverage (i.e. sewer and drain, identity recovery etc.):