OWNER'S INSURANCE PREMIUM
CREDIT REQUEST (cont.)
E . SMOKE DETECTOR | LOCATIONS: |
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Ê | Ê | Furnace Room | Ê | Ê | Kitchen | Ê | Ê | Bedrooms |
Ê | Ê | Basement | Ê | Ê | Living Room | Ê | Ê | Dining Room |
F . BURGLARY DETECTING |
| DEVICE LOCATIONS: |
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Ê | Ê | Front Door | Ê | Ê | Basement Door | Ê | Ê | Rear Door |
Ê | Ê | 1st Floor Windows | Ê | Ê | All windows | Ê | Ê | Interior Locations |
Ê | Ê | All Accessible Openings, Including Skylights, Air Conditioners and Vents |
ÊÊ Attic
ÊÊ Hall
ÊÊ All Exterior Doors
G . ADDITIONAL PERTINENT INFORMATION:
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Signature: __________________________________________________ Date: _______________________
Ð 3 8 Ð