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Address
Email Address
City and State
Zip code         
Phone Number
Date of Birth
Condo Occupancy
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Insured Now?
Male
Gender
Female
Have You Filed Any Claims In the Past 3 years
Single
Marital Status
Married
CONDO Information
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Year Built
Construction Type
Year Roof
Was Updated.
Roof Type
No
Yes
Wind Mitigation?
Square Footage
No
Yes
Gated Community?
Estimated
Value
No
Yes
Monitored Security
System?
Pool
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