Easy to use, home-owners insurance questionnaire. These are the main questions your home insurance company may ask you about your house. Please note: specialty areas such as knob and tube wiring, aluminum wiring, fireplace and woodstoves may require further information. This is for the home-owners convenience only, and to be used as a guide only.

1. (1st, bi-level, etc.)
Bo Knows Homes (204) 333-2202
Porch or Sunroom
Yes / No
Size _________
Yes / No
Wood Burning / Natural Gas
Hot Tub or Pool
Yes / No
Size _______
Deck
Yes / No
Square Footage ________
Made of _________
Electrical Systems
Panel
Circuit Breakers ! ______%
Fuse Panel ! _______%
Fuse Panel- Tamper Proof !
Year Updated __________
Electrical Service
60 Amp !
70 Amp !
100 Amp !
200 Amp !
Other ! _______ Amp
Wiring
Copper ! ___%
Aluminum ! ___%
Knob and Tube ! ___%
Year Updated _______
Roofing
Asphalt Shingles !
Wooden Shingles !
Metal !
Rubber !
Tar & Gravel !
Other !
Darcy Cook (204) 237-4025
Homeowner’s Insurance Questionnaire
Address ____________________________________________________________________
Type of dwelling _______________________________ Age of dwelling ________________
Square Footage of Home ______________ Square Footage of Basement ________________
Flooring Garage Fireplace
Yes / No
Attached / Detached
Single / Double / Triple
Plumbing Systems
Pressure Lines
Galvanized ! ___%
Copper ! ___%
Plastic/PVC/ABS/PEX ! ___%
Year Updated __________
Hot Water
Standard Tank !
Tankless !
Year Updated ______
Sewer System
Sump Pump in a Pit !
Backwater Valve !
Throat Valve !
In-line Valve !
Carpet ! _______%
Laminate ! ______%
Hardwood ! _____%
Vinyl ! _______%
Ceramic ! ______%
Other ! _______%
Heating Systems
Forced Air Furnace !
Hot Water/Boiler !
Electric Baseboard !
Hydronic/In Floor !
Geo Thermal !
Woodstove !
Central A/C !
Fuel
Natural Gas !
Electricity !
Oil !
Other ! ____________
B