
OWNER’S INSURANCE PREMIUM CREDIT REQUEST
(cont.)
E. SMOKE DETECTOR LOCATIONS
Furnace Room  | 
  | Kitchen  | 
Basement  | 
  | Living Room  | 
  | 
Bedrooms Dining Room
Attic
Hall
F. BURGLARY DETECTING DEVICE LOCATIONS: | 
  | 
  | |
Front Door  | Basement Door  | Rear Door  | All Exterior Doors  | 
1st Floor Windows  | All windows  | Interior locations  | 
  | 
All Accessible Openings, Including Skylights, Air Conditioners and Vents
G. ADDITIONAL PERTINENT INFORMATION:
Signature:  | 
  | Date:  | ||
  | 
  | 
  | 
  | 
  | 
  | 
  | 
  | 
  | 
  | 
– 54 –