New Home Questionnaire Template printable pdf download

New Home Questionnaire

Info taken from: ________ Date:________

Named Insured (on deed): ______________________Tele:______

Email address:_____________________ CELL_____________

Address: __________________________________________

Named Insured:____________________________

tell insured Credit Scoring now mandatory

DOB: _____________Social Security________________

Occupation____

Dob:__________ Social Sec#:___________occupation:___________

INTERESTED IN LIFE OR HEALTH?__________

Style of Home (Ranch, Cape, Split etc):____________

Year Built:________# of Stories:_____ Square Footage: ________

Construction type:_______

Age of Roof: ________

Date of Closing: _______ Purchase Price: _______ Mortgage amount:__________

Mortgagee address: ______________________________________________

__________________________________________________________________

Mtgee billed; ______ Contact Person & fax#: _________________

Proximity to Coast ft: __________ Distance to Fire Hydrants Station:_____

Alarms:_________ Nonsmoker:_________

Underwriting Information:

If home over 40 years, need update information for major systems:

Roof_______ Plumbing____________

Electrical: Fuses or C. Breakers, #AMPS,

wiring: _______, Heat_____: If oil, where is tank located _______

Wood/coal stove? _____, Pool type: ______, Diving Board: _______ Slide: __

fenced:_______ Hot Tub:______ Dog breed:_____________

Ferrets: ________________

Trampoline: ____________

Daycare:________________

Any business conducted on the premises:_____________

Will you occupy home immediately after closing? _________

Does insured own any ATV’s, snowmobiles, dune buggy, mini bikes, recreational

vehicles?_________

Have you had any homeowner losses in last 3 years? __________

Who is your auto carrier (account credit)? ______________

Ex-date for auto:________________

Any scheduled items? ________________ (need appraisal or bill of sale)

New Home Questionnaire Template