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Insurance Intake – Renewal
Marshall Tague
2022-11-22T13:56:39-07:00
Stewardship Insurance Renewal Intake Form
Life changes, we get it, we just need to know about it.
In order for us to accurately review your policy(s), and make sure you are covered properly, we need to know about possible changes in your life.
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Please Note:
Some of the questions in this form we already know and/or we have already asked, however, we need to verify the information is correct so we don't miss anything.
In order to assist you with questions that might come up while filling out this form, we created some helpful videos. Whenever you see a "?", click on it, and a "More Info" video will be played for your convenience.
What insurance policies do you have with Stewardship that are up for renewal? ***If you have more than one policy and those policies expire at different dates, that's ok, please fill out this form for ALL your policies.***
(Required)
Check all that apply. If you have an Umbrella, ATV, Motorcycle, and/or RV policy(s) with us, we do not need any further information to review those policies. As a result, you will not see those as options below.
Primary Home Insurance (standalone dwelling - not condo/townhome)
Condo/Townhome Insurance
Auto Insurance
Rental Home Insurance
Renter's Insurance (tenant)
The following questions are for your Home Insurance Renewal
The following questions are for your Condo/Townhome Insurance Renewal
Please list the name(s) of everyone in your household (15 years of age or older, or will be driving a vehicle, INCLUDE YOURSELF) and their relation to you.
(Required)
First & Last Name:
Relation:
Add
Remove
If more than one click the + sign to add info
Has the name or names on the Title/Deed of the Home changed?
(Required)
Yes
No
Please list all names on the Title/Dead.
(Required)
Add
Remove
If more than one click the + sign to add info
Is the home in or do you plan on putting it into the name of a Trust or LLC?
(Required)
Yes
No
What is the name of the Trust or LLC?
(Required)
Who are the Trustees - or the owners of the LLC?
(Required)
Does the Trust or LLC own any other entities (such as a business) or commercial properties?
(Required)
Yes
No
Has the mortgagee on the home changed over the past 12 months?
(Required)
(This is VERY important to ensure that payment gets made on time)
Yes
No
Who is your new mortgage company?
(Required)
What is your new loan number?
(Required)
The following questions are for your Home Insurance Renewal
The following questions are for your Condo/Townhome Insurance Renewal
Do you own a dog(s)?
(Required)
Yes
No
What type of breed(s)?
(Required)
Does your dog(s) have a bite history?
(Required)
Yes
No
Do you have any farm animals? (horses, cows, chickens, etc.)
(Required)
Yes
No
Do you have a trampoline?
(Required)
Yes
No
Does it have a net?
(Required)
Yes
No
Do you have a pool?
(Required)
Yes
No
Does it have a slide?
(Required)
Yes
No
Does it have a diving board?
(Required)
Yes
No
Does your home have solar panels?
(Required)
Yes
No
How many panels do you have?
(Required)
Do you own or lease your solar panels?
(Required)
Own
Lease
Unless already scheduled on your policy, do you have any other individual Jewelry, Fine Art, Collections/Memorabilia, Silverware, or Musical Equipment worth more than $1,500?
(Required)
Yes
No
Would you like to schedule those items onto your policy to ensure they are fully protected?
(Required)
Yes
No
What is the item(s)?
(Required)
Item Description:
What is its value? ($0.00)
Add
Remove
If more than one click the + sign to add info
The following questions are for your Home Insurance Renewal
The following questions are for your Condo/Townhome Insurance Renewal
Have you done any major renovations (roof, plumbing, electrical, all new flooring, remodeled kitchen and/or bathrooms) to the home in the past year?
(Required)
Yes
No
Have you done any major renovations (plumbing, electrical, all new flooring, remodeled kitchen and/or bathrooms) to the home in the past year?
(Required)
Yes
No
Briefly describe what was updated and when:
(Required)
What?
When? (mm/yyyy)
Add
Remove
If more than one click the + sign to add info
Do you plan on doing any major renovations to the home in the next 12 months?
(Required)
Yes
No
What type of renovations are you planning on?
(Required)
Will the home be vacant while the work is done?
(Required)
Yes
No
Do you run a business out of your home? ***NOT THE SAME AS WORKING FROM HOME***
(Required)
If you work from home (not run a business out of your home), please select "No".
Yes
No
Does it require foot traffic?
(Required)
Yes
No
What type of business?
(Required)
Are you renting out any part of your home?
(Required)
Yes
No
Is the lease a long-term (12mo) agreement or short-term (Airbnb/VRBO) agreement?
(Required)
Long-term
Short-term
The following questions are for your Home Insurance Renewal
Unless already on your policy, are you interested in adding Buried Utility Lines/Service Lines coverage to your homeowners policy?
(Required)
Yes
No
Are you interested in a separate Home Warranty quote as well?
(Required)
Yes
No
Would you like a quote to bundle your Auto policy?
(Required)
Don't forget, bundling can save you money.
Yes
No
The following questions are for your Condo/Townhome Insurance Renewal
Are you interested in a separate Home Warranty quote as well?
(Required)
Yes
No
Would you like a quote to bundle your Auto policy?
(Required)
Don't forget, bundling can save you money.
Yes
No
The following questions are for your Auto Insurance Renewal
Please list the name(s) of everyone in your household (15 years of age or older, or will be driving a vehicle, INCLUDE YOURSELF) and their relation to you.
(Required)
First & Last Name:
Relation:
Add
Remove
If more than one click the + sign to add info
Please confirm your physical address:
(Required)
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Is your mailing address different than your physical address?
(Required)
Yes
No
Please confirm you mailing address:
(Required)
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Has the household driver situation changed?
(Required)
Please note - ALL household drivers need to be listed on your policy EVEN if they need to be Excluded from your coverage.
Yes
No
Is there someone we need to remove?
(Required)
Please note - They can not be removed if they still live in your house.
Yes
No
Who needs to be removed?
(Required)
Is there someone we need to add?
(Required)
