Annual Client Review (Property & Auto) Your Name First Last Your Email Your PhonePhone TypeCellHomeWorkSpouse's Name First Last Spouse's Email Spouse's PhonePhone TypeCellHomeWorkYour Property InsurancePlease check oneHave any members of the household recently married, moved out, separated, or divorced? Yes No N/A Do you own any additional properties or vacant land that we don’t currently insure? Yes No N/A Are any of your properties or vacant land titled in a trust or LLC? Yes No N/A Flood, Sinkhole, and Earthquake are some exclusions in a Homeowner’s policy. Are you aware you can purchase these coverages? Yes No N/A Have you done any updates to your home recently? Examples: added an addition, replaced the roof or heater, finished the basement, built any detached structures, pools, or garages Yes No N/A Do you own any trailers, watercrafts, jet skis, recreational vehicles, snowmobiles, ATVs, or motorized golf carts that we don’t currently insure? Yes No N/A Do you own any jewelry, fur, silverware, musical instruments, stamps/coins/guns/fine arts or collectibles that we don’t currently insure? Yes No N/A Are any members of your household not related to you? Yes No N/A If you have children, are any of them full-time college students? Yes No N/A Are any of the members of your family living in an assisted living facility or nursing home? Yes No N/A Do you have a home-based business? Yes No N/A Is any part of your home available for rent (including vacation rental or home sharing/swapping Yes No N/A Do you babysit or operate a child daycare in your home? Yes No N/A Have you notified us if you refinanced, changed mortgage companies, or paid off your mortgage in the past year? Yes No N/A Your Car InsurancePlease check oneHas anyone in your household acquired a vehicle that is not already listed on your policy? Yes No N/A Are any of the vehicles listed on your policy titled to someone other than you? Yes No N/A Are any of your vehicles used for business purposes? This includes, but is not limited to: snow plowing, food delivery, and driving for ride sharing services such as Uber or Lyft Yes No N/A Are any of your vehicles available for rent via a car sharing service such as Turo or Zipcar? Yes No N/A Do you have a company car? Yes No N/A Do you have any classic or antique cars that we don’t currently insure? Yes No N/A Do you own a motorcycle that we don’t currently insure? Yes No N/A Do you want Roadside Assistance/Towing coverage? Yes No N/A Do you want to be able to rent a car if your car is damaged in an accident? Yes No N/A Have you recently lost your medical insurance? Yes No N/A Are any of your vehicles customized? Yes No N/A Are all drivers in your household listed on your policy? Yes No N/A Our agency also sells Life, Disability, and Long Term Care Insurance. Is this something you’d like to learn more about? Yes No N/A Would you like to opt-in to our text alerts? Examples: Office closures, customer satisfaction and claim surveys, etc. Yes No N/A Please provide any additional comments or concerns: Δ