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Contact
Secondary / Seasonal Renewal Questionnaire
Name
*
Date
*
MM slash DD slash YYYY
Email
*
Phone
*
Primary Home Address
*
Primary Home Insurance Agency / Company
After reviewing the attached summary of insurance, are there any changes that need to be made to your policy?
Choose one...
Yes
No
Please List:
*
Do you share ownership of your secondary / seasonal home with other family members?
Choose one...
Yes
No
Please list:
*
Is your property held in a trust?
Yes
No
If YES, the name of the trust:
How frequently do you visit your second home?
Is your home accessible year round (plowed to allow fire trucks or emergency personnel to access the property)?
Choose one...
Yes
No
Do you rent your home?
Yes
No
If YES, how many weeks per year?
Have you made any recent improvements or upgrades to your home?
Choose one...
Yes
No
Please list:
*
Do you have an auto that is registered and garaged in New Hampshire?
Choose one...
Yes
No
Please provide detail:
*
Do you have a boat that is kept in New Hampshire?
Choose one...
Yes
No
Please provide detail:
*
Flood Insurance is not covered by your homeowners policy, unless you have already purchased it, would you be interested in a flood insurance quote?
Choose one...
Yes
No
Earthquake coverage is not covered on your homeowners policy, unless you have already purchased it, would you be interested in a quote for this coverage?
Choose one...
Yes
No
We are always looking at ways to improve our service to our clients. Please let us know how we are doing and if there are things we could do to improve:
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