Insurance Insurance Client Information Name: Phone Number: Email Address: Property Address: Type of Property: Single Family Home (SFH)TownhomeCondo Is this a Primary Residence, Investment Property, or Second Home? Primary ResidenceInvestment PropertySecond Home Do you currently have insurance? YesNo If yes, please provide the following: Current Annual Premium: Name of Insurer: Please provide a copy of your current insurance declaration page (click the button below to upload document) Upload Declaration Page: Roof Roof Age (years): Wind Mitigation Details Do you have hurricane shutters? YesNo Are shutters installed on all windows? YesNo Do you have hurricane impact windows? YesNo Additional Information:
