3.C.6

HOMEOWNERS INSURANCE REVIEW CHECKLIST

Please take a moment to complete this form. Because aspects of your life
change from year to year, you and your agent should use this form for
discussion to assure that you are properly covered.

Do you have collectibles: antiques, fine art, stamps, coins, etc.?	Yes  No
Do you have costly sporting equipment or firearms?	Yes  No
Do you have valuable jewelry or furs?	Yes  No
Do you have valuable photography equipment?	Yes  No
Do you have a business in your home?	Yes  No
Do clients or customers come to your home?	Yes  No
Do you keep a large amount of others' business property in your home?	Yes  No
Do you have a computer in your home?	Yes  No
Do you own professional tools or equipment?	Yes  No
Do you keep samples or items for sale in your home?	Yes  No
Do you baby-sit or have child day care in your home?	Yes  No
Do you own rental or income property?	Yes  No
Are your contents covered for "replacement value'?	Yes  No
Do you have a secondary residence?	Yes  No
Do you own investment property?	Yes  No
Have you installed home fire or security alarms?	Yes  No
Do you keep more than $250 cash in your home?	Yes  No
Do you own recreational vehicles: boat, jet-ski, camper, cycle, etc.?	Yes  No
Have you remodeled your home? Have plans to do so?	Yes  No
Do you have "umbrella" liability coverage?	Yes  No
Do you have an above ground or in ground swimming pool?	Yes  No
Do you have detached structures: gazebos, storage barn?	Yes  No
Do you have a satellite dish?	Yes  No
Do you have pets?	Yes  No
Do you have roomers or boarders?	Yes  No
Do you have domestic help, babysitters, landscapers, and house cleaners?	Yes  No
Do you travel frequently (domestic or foreign)?	Yes  No
Do you have a wood burning stove?	Yes  No
Do you have a fireplace?	Yes  No
Have you had your chimney professionally cleaned and inspected within the last 12 months?	Yes  No
Do you have flood insurance?	Yes  No
Is there or has there ever been evidence of water leakage or seeping in the residence?	Yes  No
Do you have earthquake insurance?	Yes  No
When was the last time you refinanced your mortgage? mm/dd/yy	/          /
Are you interested in protecting yourself from identity theft?	Yes  No
Is your home insured correctly should you sustain a total loss?	Yes  No
Would you complete a residence cost estimator?	Yes  No