Request For Townhome Proposal

Your Personal Information
Type Of Request
The Number Of Home Claims	Within Last 3 Years
Your Name
Social Security Number	123-45-6789
Your Date of Birth	mm/dd/yyyy
Phone
Your Email
Property Address
City
State
Zip Code
About Your TownHome
Type of Dwelling/Building
Number of Units
Year Built
Is It Within City Limits
Square Feet Above Ground
Square Feet Below Ground	(Basement)
The Exterior Finish Of The Property - Should Total 100%
Wood Siding	Please List Percent of Each Type Of Material
Stone	Please List Percent of Each Type Of Material
Stucco	Please List Percent of Each Type Of Material
Security
Burglar Alarm
Fire Alarm
Fire Sprinkler System
Dollar Value Of Personal Property You Own?
Is the Building Being Insured Through Your HOA?
Any other comments, questions?