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Ramsburg Family Insurance Review Homeowners only


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

First Name
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Last Name
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Social Security Number
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E-Mail Address
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Home Phone Number
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Work Number
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Cell Phone Number
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Occupation
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Highest Level of Education
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Spouse Name
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E-Mail Address
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Work Number
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Cell Phone Number
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Occupation
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Preferred method of contact
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Homeowners Coverage
Please Enter Yes or No for the following Questions
Have you or are you planning on investing $15,000 or more in renovating your home? (Interior or exterior)
Optional

If yes, projected or finished date of renovation.
Optional
/ /
Please provide approximate years of updates or repairs to the following:
Plumbing System
Required
Electrical System
Required
Roofing
Required
Exterior
Optional
Roof
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Type of Fuel
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Please Enter Yes or No for the following Questions
Do you have any supplemental heat such as a wood, coal, pellet or gas stove?
Optional

Does your home have a security system?
Optional

Homeowners Insurance does NOT cover floods/earthquakes. Would you like to receive information on Flood Insurance?
Optional

Is your basement Finshed ?
Optional

If Yes, Approximate value of the finished area
Optional
Do you have a sump pump?
Required

Do you have Backup of Sewer and Drain Coverage?
Optional

If yes, do you need higher limits on Sewer or Drain Coverages?
Optional

Do you have any structures on the property that are not attached to your home—such as a garage, pool house, cabana, gazebo, pergola, sports court, and outdoor living area (built in barbeque or rock/masonry seating areas)?
Required

Do you own any boats, jet skis, recreational vehicles, snowmobiles, ATV’s or golf carts?
Required

Do you own any items valued over $1,000? (i.e. Furs, Fine Arts, Guns , Coins, Other Collectible Items)
Required

Jewelry
Optional

Furs
Optional

Fine Arts
Optional

Sliverware
Optional

Guns
Optional
Electronics
Optional

Musical Instruments
Optional
Coins / stamps
Optional

Cameras
Optional

Other Collections
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Is there any type of business activity in the home or on the premises? Activities such as in-home daycare, babysitting services, home-based office, farming operations (owned or leased) or garage operations?
Optional

Do you have professional tools or equipment on your premises for business use?
Required

Do you have a pool on your property?
Required

If yes, is it an In-ground or Above-ground pool?
Optional

Is the pool fenced or have a locking or removable ladder?
Optional

Do you have a ..... ?
Trampoline
Required

Skate Ramp
Optional

Tree House
Optional

Other Recreational Structure
Optional

Are any of your children attending school away from home?
Required

If yes, number of students attending school away from home:
Optional
On or off campus?
Optional

Do they have high value items with them at school?
Optional

Identity theft is one of the fastest growing crimes. Statistics show there are more that 15 million victims a year and over $50 billion in damages. Identity Theft resolution services are offered by many insurance carriers.
Would you be interested in receiving information to add this protection?
Optional

Have you refinanced or paid off your home?
Required

If yes, Do you have a water intrusion alarm or battery back up?
Optional

Are any members of your household living in an assisted living facility?
Optional

Do you have a vacation home or 2nd residence?
Optional

Important Concerns
Is the Liability Limits of your Policy Adequate to cover your Personal Assets in the event of a Lawsuit?
Optional

Have you made any major lifestyle changes that might alter your insurance needs? Marrying, Divorcing or Retiring?
Optional

Have you changed the ownership structure on your property? (Started a Trust or an LLC?)
Optional

If you have Life Insurance, do you have enough coverage to pay off your home mortgage?
Optional

Do you have Long Term Disability Insurance to Protect you family if you were disabled?
Optional

Are you interested in protecting your retirement assets with Long Term Care Insurance?
Optional

Ask yourself, “How will my family manage financially if I die?” We have affordable insurance plans and life insurance rates have dropped significantly within the past few years.
Do you have the protection that your family will need to maintain their lifestyle or pay for college? When was the last time you had a financial check-up?
Additional Notes, Information & Instruction
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Submission Validation
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
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