Home Insurance - CMR & Associates

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Home Insurance

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Step 1 of 7 - Zip Code

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Zip Code*

First Name*
Last Name*
Street address of home to be insured*
City*
State*
Do you own a dog?*

How do you describe this home?*
Do you currently have home insurance on this property?*
If you answered yes to question above, what company?
In the last 6 years how many claims have you had at this property or any residential property you own?*

Year home was built*
Approx. Square Footage*
Type of Home
Home Design
Year roof was installed
Roof Type*
Sape of Roof
Type of Garage
Garage Placement
Foundation
Construction
Do you currently have home insurance?
Upload copy of your policy

Number of Kitchens*
Kitchen Grade
Number of Bathrooms
Bathroom Grade
Half Bathrooms?
Number of Fireplaces?

Is there a heat pump?*
- Yes
- No
Is there central air conditioning?*
- Yes
- No
Is there a wood pallet or coal stove?*
- Yes
- No
Are there steps or risers without handrails on the dwelling or other structures?*
- Yes
- No
Is there a swimming pool? Please explain.
Upload and image of the house if you would like.
Drop files here or

Additional Home Features? Please explain
Distance to the nearest fire hydrant
Are you over 50 years old, retired and living in your residence 10 months a year?