Please complete the following home information:        
                         
        Property Address: 
                    City: 
                   State: Zip: 
                  County: 
I will  ownrent this house

This is my:  PrimarySeasonalresidence
* If this is a seasonal residence what is your primary home address?
	    Home Address: 
                    City: 
                   State: Zip: 
                  County: 


Construction Type:  frame masonry other   Year Built: 
Is property within 4 Miles of water? yes no 
Distance to Water: 
Name/Description of Water Exposure: 

Is Flood Insurance Required?: yes no 
Flood Zone: 

If property is over 30 years old
please provide year of system update:
                 Heat:     Electric: 
             Plumbing:         Roof:  
 
Roof Type: Is there a flat roof? yes no 

No. of Stories:  1 1-1/2 2 2-1/2 3 other     

Ground Floor Square Footage: 
No Full Baths:   No of 1/2 Baths 

          Basement:  none unfinished finished other   Square Footage: 
             Porch:  none enclosed open    Square Footage: 

Garage:  none 1-car 2-car 3-car other   Type:  none attached detached built-in other


Heat Type:  none gas oil electric other

If Oil:
Oil Tank on Property: yes no  Tank Age: 

Oil Tank:  none underground above ground in basement

Central Air Conditioning:  yes  no          Using heat ducts?   yes  no
or separate A/C unit?  yes  no


Fireplace: yes no
Number of Fireplaces: 

Wood Burning Stove: yes no

List Household Pets/Types. If No pets please type NONE:


Is there a swimming pool on the property?  yes     no
 Is there a diving board or slide?   yes   no

 

Is this a new purchase?  yes   no     Purchase price: 
Is there a fully executed contract: yes no       Closing Date:  
Mortgage Company Name:  
Mortgage Company Address:
City: State: Zip:
Contact Person:  
Phone Number:  
Fax Number:  

Any additional information?