Rental Dwelling – HRRE Form submitted by: * Email * Phone * Property Owner’s Name * Name on Title * Title Holder’s Mailing Address * Owner/Trustee’s Birthdate * Owner/Trustee’s Email Owner/Trustee’s Phone * How many rental properties does the owner/trustee own? Insured Location Address * Requested effective date? * Year Built * Square Footage? * Foundation Type * Slab Basement Crawl Space Pilings/Stilts Hillside Foundation Other Roof Update Year Electrical Update Year Plumbing Update Year AC Update Year Heating Update Year Water Heater Update Year Type of Garage? * None Attached Detached Carport Number of Garage Stalls Any detached structures (other than garage, if applicable)? E.g. storage shed Yes, please specifyYes, please specify No Does the property have the following? Pool Trampoline Type of Fire/Smoke Alarm * None Local Central Type of Burglar Alarm * None Local Central Mortgagee & Loan Information, if applicable Estimated Tenants? * Will tenants be allowed pets? * Yes No Projected Length of Lease * 12 Months 6 Months 1 Month Other, please specifyOther, please specify Estimated Monthly Rent $5000$0$10000 Current Insurance Policy Choose File Maximum upload size: 10MB Comments If you are human, leave this field blank. Submit
