PL Home Renewal Questionnaire Step 1 of 5 20% Name First Last Email PhoneAre you driving for a rideshare or delivery company?(Required) Yes No If yes what company?Have you started using your vehicle for business?(Required) Yes No (Roofing, real estate, advertisement, etc.)What Business?Please check all life events that have occurred in the last 12 months.(Required) Address Change Home renovations/improvements Started A Business Other Change No Changes Date You Moved MM slash DD slash YYYY Updated Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code What type of property did you purchase? Primary Home Rental Home/Investment Property Second Home/Vacation Home Date Purchased MM slash DD slash YYYY New Property Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is the Property currently insured? With who? What is the name of your business?What is the industry of your new business?Is your business currently insured? Yes No Do you have life insurance independent of your employment?(Required) Yes No Not Sure Please select all property that you own even if it is not insured with our agency.(Required) ATV Auto Boat/Yacht Business Classic Car Condo Golf Cart Home Motorcycle Rental Property RV Slingshot Snowmobile Vacation Property It is important to know if you own any of the items above because coverages can overlap or leave gaps and you need to be covered correctly.Do you own an ATV?(Required) Yes No Do you own a boat/yacht?(Required) Yes No Do you own a business?(Required) Yes No Do you own a business?(Required) Yes No Do you own a Classic Car?(Required) Yes No Do you own a golf cart?(Required) Yes No Do you own a motorcycle or slingshot?(Required) Yes No Do you own a rental/investment property?(Required) Yes No Do you own an RV?(Required) Yes No Do you own a snowmobile?(Required) Yes No Do you own a vacation property?(Required) Yes No Are there any additional changes that we should know about prior to your insurance renewal?PhoneThis field is for validation purposes and should be left unchanged.
