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Homeowners Quote — Fusco Insurance

Tell us about the home once, in plain English. Your answers go straight into the standard industry application (ACORD 80 — the form every homeowners carrier uses), and we shop your quote and come back with real numbers. No obligation, and no coverage is bound by this form. Takes about 7–9 minutes. Renting the home out, or it's a second home? This form handles that too — it routes to the dwelling fire application (ACORD 84) instead.

Applicant & property

Your full name (as it should appear on the policy)

Email

Phone

Mailing address, if different from the home's address

In which state is the home located?

The home's address (street, city, ZIP)

Date of birth (optional on this form - some carriers use it in rating; you can give it on our call instead)

Occupation / employer (general - retired is fine)

Co-applicant (spouse/partner) name, if they should be on the policy

Requested effective date

Occupancy & use

How is the home used?

How many families live in the home?

Is any business run from the home?

A
B

If yes, please describe the business

Is any part of the home rented out (including short-term/Airbnb)?

A
B

If yes, please describe

The home itself

Type of home

Year built

Construction

Living-area square footage (approximate is fine)

Number of stories

Roof material

Roof age or year last replaced/re-roofed

Heating system & fuel

Is there a wood stove?

A
B

Plumbing: updated in the last 20 years?

Plumbing update year, if known

Electrical: updated in the last 20 years?

Electrical update year, if known

Heating: updated in the last 20 years?

Heating update year, if known

Basement

Fire protection: miles to the nearest fire station

Is there a fire hydrant within 1,000 feet?

A
B
C

Alarm / protection systems

Pool, trampoline, or wood stove?

If yes, please describe

Dogs or other animals on the premises? Breed(s), if dogs

Coverage & current policy

What do you estimate it would cost to rebuild the home today? (A range is fine - we run a replacement-cost estimate on every quote; enter Not sure - run the estimate if you don't know)

Deductible preference

Valuable items to schedule (jewelry, art, instruments, collections over $1,500 each)

Do you have homeowners insurance now?

A
B

If yes: current carrier

If yes: current policy expiration date

If yes: current dwelling limit, if known

Has a carrier cancelled or non-renewed your home coverage in the last 5 years?

A
B

If yes, please explain

Any claims on this home or any prior home in the last 5 years?

A
B

For each claim: year, what happened, amount

Mortgage company (lender) name - and a second lender/HELOC, if any