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Homeowner Insurance Questionnaire

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Easy to use, home-owners insurance questionnaire. These are the main questions your home insurance company may ask you about your house. Please note: specialty areas such as knob and tube wiring, aluminum wiring, fireplace and woodstoves may require further information. This is for the home-owners convenience only, and to be used as a guide only.

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Homeowner Insurance Questionnaire

  1. 1. (1st, bi-level, etc.) Bo Knows Homes (204) 333-2202 Porch or Sunroom Yes / No Size _________ Yes / No Wood Burning / Natural Gas Hot Tub or Pool Yes / No Size _______ Deck Yes / No Square Footage ________ Made of _________ Electrical Systems Panel Circuit Breakers ! ______% Fuse Panel ! _______% Fuse Panel- Tamper Proof ! Year Updated __________ Electrical Service 60 Amp ! 70 Amp ! 100 Amp ! 200 Amp ! Other ! _______ Amp Wiring Copper ! ___% Aluminum ! ___% Knob and Tube ! ___% Year Updated _______ Roofing Asphalt Shingles ! Wooden Shingles ! Metal ! Rubber ! Tar & Gravel ! Other ! Darcy Cook (204) 237-4025 Homeowner’s Insurance Questionnaire Address ____________________________________________________________________ Type of dwelling _______________________________ Age of dwelling ________________ Square Footage of Home ______________ Square Footage of Basement ________________ Flooring Garage Fireplace Yes / No Attached / Detached Single / Double / Triple Plumbing Systems Pressure Lines Galvanized ! ___% Copper ! ___% Plastic/PVC/ABS/PEX ! ___% Year Updated __________ Hot Water Standard Tank ! Tankless ! Year Updated ______ Sewer System Sump Pump in a Pit ! Backwater Valve ! Throat Valve ! In-line Valve ! Carpet ! _______% Laminate ! ______% Hardwood ! _____% Vinyl ! _______% Ceramic ! ______% Other ! _______% Heating Systems Forced Air Furnace ! Hot Water/Boiler ! Electric Baseboard ! Hydronic/In Floor ! Geo Thermal ! Woodstove ! Central A/C ! Fuel Natural Gas ! Electricity ! Oil ! Other ! ____________ B

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