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HOME
QUESTIONNAIRE
- For your
convenience Tashjian Insurance Agency, Inc. keeps their fax
lines open at all times. Please print out this sheet and fax it to
626.357.5037.
General
Information:
- Contact
Name:
- Contact
Phone: E-Mail Address:
- Street
Address:
- City:
State:
Zip Code:
-
Dwelling Information:
- Year Built:
Square Footage:
-
- Roof Type:
-
- Fireplace
Yes No
-
- Central Air
Yes No
-
- Pool
Yes No
-
- # Bedrooms:
# Bathrooms:
# Floors:
-
- Primary Use:
Primary Residence Rental
Dwelling Secondary
Residence
Additional Features:
- Central Alarm Yes
No
-
- Fire Sprinklers Yes
No
-
- Enclosed Patio Yes
No
-
- Central Vacuum Yes
No
-
- Sky Lights Yes
No
-
- Marble Tile Yes
No
Dwelling Improvements:
Check All That Apply
- Roof: Yes
No
-
- Plumbing: Yes
No
-
- Electrical: Yes
No
-
- Heating: Yes
No
-
- Exterior Paint: Yes
No
-
COMMENTS/REMARKS:
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