Gold Star Insurance

Property Insurance Questionaire

Getting the right property insurance starts with understanding your home. This short questionnaire helps our team at Gold Star gather the details we need — from your home's condition and utilities to pets, safety features, and liability considerations — so we can find you the best possible coverage. There are no wrong answers, and everything you share stays confidential. Take a few minutes to fill it out completely, and one of our licensed agents will follow up with personalized recommendations tailored to your property and your peace of mind.

Name
Address of Property

Dwelling Information

Is your home under construction, or undergoing any renovations or repairs?
Is there any significant pending home maintenance?
e.g. Rotting wood, Broken windows, Mossy roof, Missing siding, etc.

Utilities

Has your Heating system been installed/updated in the last 30 years, or inspected in the last 5 years?
Has your Plumbing system been installed/updated in the last 30 years, or inspected in the last 5 years? (copy)
Has your Electrical system been installed/updated in the last 30 years, or inspected in the last 5 years? (copy) (copy)
Is the Electricity controlled solely using circuit breakers?

Liability

Is there any business activity conducted on the premises?
e.g. Music lessons, Vegetable stand, Day care, etc.
Is there any of the following on the premises: Abandoned autos, Discarded appliances, Abandoned buildings, Treehouses, or Ponds?
Is there a pool?
Is there a trampoline?

Fuzzy Friends

Are there any dogs on the premises?
Are there any unusual pets?
e.g. Chickens, Snakes, Ferrets, Goats, etc.

Safety

Does your home contain any of the following safety and damage mitigation measures?

Additional Coverages

Two common exclusions to a typical property insurance policy are losses due to Flood and Earthquake. Would you like additional information on coverage for these risks?
Do you have any jewelry listed on your current property insurance, or are you interested in additional jewelry protection?
We may recommend additional liability protection for households with increased risks such as pools, or increased assets such as high income and multiple properties. This additional coverage is called an Umbrella policy. Would you like additional information?