Personal Insurance Renewal Review - Catalyst Insurance Group

Today's Date*
MM slash DD slash YYYY
Client Name*
Please Enter the name listed first on your insurance policies
First Last
Mailing Address*
Street Address City State ZIP Code
Mobile Phone:*
Text Messages*
Please let us know if you approve contact via text message
Email Address*
Please Provide Us With Your Best and Preferred Email Address
Preferred Method of Contact*

Acknowledgements
Acceptance of Coverage*
Your input is ESSENTIAL in our attempt to eliminate gaps in your insurance coverage. Please accept that you have reviewed your current and existing insurance policy(ies) and accept the coverages you currently have. This checklist is used prior to the renewal of your insurance policy(ies) for the purpose of verifying your coverage is up to date. This checklist does not cover every situation, but is a starting point to prompt you to consider major items and questions.
- Yes I accept
Acknowledgement of Truth and Good Faith*
I hereby certify that all statements included in the checklist are true and correct to the best of my knowledge. I understand that any false statements may lead to claims being denied, premiums to be adjusted, and/or policies ultimately canceled.
- Yes, I certify the following answers to be true

Renters Policy
Please review the personal property limit on your renters policy. Do you feel this limit is adequate to replace all the "stuff" in your apartment?*
What should the limit be?*

Homeowners
Purchased Property?*
Have you bought or sold a house, vacation property, farm, vacant land since your last insurance review?
If Yes, Please Describe
Mortgage Company*
Have there been any recent changes in your mortgage company information? Does anyone, except a mortgagee, have financial interest in your home? Do you have a second mortgage or home equity line of credit?
If yes, Please describe home based business operations*
Home - Outbuildings*
Is the "Other Structures (Coverage B)" adequate to cover all outbuildings, shops, sheds, detached garages, carports, fences, awnings, etc?
If No, Please provide a limit and description for all additional structures*
Home - Updates and Improvments*
Have there been any additions or updates to your home? Ex remodeling, improvements, additions, updates to the water, heating, plumbing, electrical or roof? *Is the amount of insurance on your home less than it would take to rebuild it?
If Yes, Please provide a value and description for all improvements*
Home Sharing*
Do you rent your home as part of a home-sharing/renting program like AirBnb, VRBO or other?

Acknowledgements