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OWNERS INSURANCE PREMIUM CREDIT REQUEST(cont.)
E. SMOKE DETECTOR LOCATIONS
Furnace Room Kitchen Bedrooms Attic
Basement Living Room Dining Room 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: