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    State Where Your Home or Property is Located

    Your Name and Contact Information

    Home and Insurance Information

    Property Type (Please select one)

    Construction Type (Please select one)

    Type of Roof (Please select one)

    Do Wind Mitigation updates exist?(Please select all that apply)

    Opening Protection such as Storm Shutters or Impact Resistant Windows?

    If yes, please provide opening protection details:

    Other home and property features? Please select all that apply:

    Have any hurricane claims been made for this home in the past three years?

    Does the house have a roof-mounted solar array?

    Is the home on posts or pilings?

    If yes, what type of pilings?

    Is your Homeowners policy a FAIR Plan Policy?

    Do you have a copy of the WPI-8/WPI-8-C form from the Texas Department of Insurance?

    How did you learn about getting a policy quote? (Please select one)
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    If you were referred to us by someone, please tell us their name.