Property Shark Search Dwelling Fire Application Property Type * Dwelling Condo Co-op Number of Units 1 2 3 4 New Purchase? * Yes No Purchase Price $ Loan Amount $ Effective Date * MM DD YYYY Estimated Premium $ LLC / CORP NAME Named Insured #1 * First Name Last Name Named Insured #1 : DOB * MM DD YYYY Named Insured #2 First Name Last Name Named Insured #2 : DOB MM DD YYYY Insured Location * Address 1 Address 2 City State/Province Zip/Postal Code Country Mailing Address Address 1 Address 2 City State/Province Zip/Postal Code Country Coverage A - Dwelling Limit $ Coverage B - Other Structures $ Coverage C - Personal Property $ Coverage D - Loss of Rent $ Deductible $ Hurricane Deductible Square Footage: Construction Type Frame Masonry Masonry Non-Combustible Fire Resistive Usage Type Tenant Vacant Owner / Tenant Year Built: # of Stories Foundation * Finished Basement Partial Basement Unfinished Basement Crawlspace Slab Property Condition Excellent Good Average Below Average What type of heating does the home have? (Gas, Oil, Etc.) Protection Class Alarm Local Central Year of Updates Phone * (###) ### #### Email * Thank you!
