OWNER’S

lNSURANCE

PREMIUM

 

 

 

CREDIT

REQUEST

(cont.)

 

:.

SMOKE

DETECTOR

LOCATIONS:

❑ B(?ciromrls

 

 

 

❑ Furnace Fioom

❑ Kitchen

m

Atii.

 

❑ 13asf?rnent

❑ Li.ingl%.fn

❑ Dining Room

~

Hall

‘ .

BURGLARY

DETECTING

DEVICE LOCATIONS:

❑ All Exterior Door.

 

~ l=rol-ltDoor

❑ BasemerltDoor

❑ Rear c)ool’

 

❑ I.t F1..rWindow.s

❑ Allwinclows

❑ Interior Locations

 

❑All Accessible Openings, Including Sl@igMs, Air Conditioners and Vents

;. ADDITIONAL PERTINENT INFORMATION:

Signature”

Date:

–38–