OWNER'S 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: _________________________________

– 38 –