Residence Rented to Others Form

What is your first name? **

What is your first name? *

What is your last name? **

What is your last name? *

What is your email address? **

What is your email address? *

What is your phone number? **

What is your phone number? *

Please enter the address of the location that is being rented.

Street Address Address Line 2 City State ZIP Code

Which best describes the tenant of this property?

Family
Friend

What is the length of the rental period?

Annual
Short-Term (weekly or monthly rentals for more than 6 months of the year)

Is the location listed on any rental marketplaces? (Select all that apply)

VRBO
AirBnB
Other

Please list the other marketplace(s) where this location is listed.

Please share the listing URL.

Is the location rented out to corporations or for special events such as weddings or charitable events, etc.?

Yes
No

Please list the events this location is rented out for.

Is there a management company contracted for this rental?

Yes
No

Does the management company have at least $1M in liability coverage?

Yes
No
Not sure

How is the property maintained?

Caretaker
Property manager
Directly overseen by the member themselves

Does the renter carry their own rental policy for personal property and liability coverage?

Yes
No
Not sure

Documents and Comments

Please use this field to upload any relevant insurance documents.

Drop files here or

Max. file size: 128 MB, Max. files: 10.

Please enter any additional remarks in the space below.

Disclaimer: This online questionnaire is a tool used to gather information. It is not an application for insurance. No insurance coverage will be bound or put into effect by submitting this form.

Consumer disclosure: By checking the box below you authorize the Agency who supplied this form to you to contact you via phone, email, and text messaging; to save and share with business partners the information you provided; to obtain consumer reports that may include credit-based reports (where legally allowed), public records, claims history, and driving records so that they can give you accurate insurance quotes. *

I agree*

Residence Rented to Others Form

Documents and Comments

Nat Worden

RiskRevu^TM Newsletter

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Residence Rented to Others Form

Documents and Comments

Nat Worden

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RiskRevuTM Newsletter

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RiskRevu^TM Newsletter