Annual Risk Review

Name *

First Name

Last Name

Phone *

(###)

###

####

Have you made or do you plan to make any changes or improvements to your home? *

Yes

No

I rent

Has your mortgage company changed recently? *

Yes

No

I rent

My home is paid off

Do you own any jewelry, art, or collections valued at $500 or more? *

Yes

No

Do you own a Jet-Ski, ATV, or Snow Mobile? *

Yes

No

Do you have any insurance policies with other carriers? (auto insurance, home/renters insurance, life insurance, disability, long term care, etc.) *

Yes

No

If you or your partner's income suddenly stopped would that be a burden to anyone? *

Yes

No

Are there any new household members in your residence or has anyone moved out? *

Yes

No

Does anyone in your household own a business or run a business out of your home? *

Yes

No

In the last 5 years, have you or anyone in your household changed jobs? *

Yes

No

When it comes to investing is there anything more important to you than getting the maximum expected return for the level of risk you are comfortable with? *

No

Yes

Do all people in the household have the insurance carrier app installed on their smartphone for access to insurance cards, etc.

Yes

No

no vehicle

Do you plan to buy/sell/refinance any properties in the next 2 years?

Buy

Sell

Refinance

*

Do you feel you are receiving outstanding service from our firm?

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree