Client Name* First Middle Last Date of Birth* Phone Number* Email Address* Renewal Date* Property Address* Wall Type Roof Type Security Deadlocks on DoorsWindow Locks/bars/grillsAlarms Building Contents Cover Options Listed Events ( Fire, Theft, storm )Accidental Damage ( Listed Events and accidental damage in home )Landlord Insurance Landlord Insurance Landlord Insurance Options Loss Of RentRent Default & Tennant Theft Weekly Rent $ Claims History Claims History (Within the past 5 years) -+