https://www.eastcoastinsuranceservices.com/wp-content/uploads/sites/52/2020/06/Add-New-Page-‹-East-Coast-Insurance-Services-—-WordPress.mp4 Home Insurance Renewal Form Step 1 of 7 14% Full Name*Date* Date Format: MM slash DD slash YYYY Phone Number*Email* Preferred Contact Method*TextEmailPhone Any major life changes over the last year?* Got Married/Divorced Started a New Job Had Children Started a New Business Other None Describe Other Response Is this your primary residence?*YesNoHow would you rate the current condition of the home?*ExcellentGoodFairAny detached structures (shed, detached garage, etc)?*YesNoIf so, please describe use and condition. Do you have any jewelry pieces over $1500 in value?*YesNoDo you have any fire arms? Do they exceed $10,000 in combined value?*YesNoDo you have any collectible items? Baseball cards, wine, etc?*YesNoPlease describe your collectibles and provide approximate value Do you have a swimming pool?*YesNoIs it fenced and locked?YesNoDoes it have a diving board or slide?YesNoDo you have a trampoline?*YesNo Do you currently have life insurance protection?*YesNoIs your life coverage through work?YesNoWould you like a life consultation with one of our experts to review and asses your needs to better protect your family?*YesNo Do you own a business?*YesNoIs it operated out of your home?YesNoName and description of businessDo you own any of the following?* Automobiles Motorcycle RV/Camper/Golf Cart Year/Make/Model of Selected Items + Current Insurance Company*Do you currently have umbrella insurance coverage?*YesNoDo you currently have flood insurance coverage?*YesNoDo you have any questions about your insurance coverage?