256-232-7818
122 W. Market Street
Athens, Alabama 35611
256-232-7818
4205 Balmoral Drive
Huntsville, Alabama 35801

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Condo Insurance

Pepper, Johnstone & Company

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Personal Information

First & Last Name ✶

Street Address ✶

City ✶

State ✶

ZIP Code ✶

Email ✶

Phone ✶

Date of Birth

Occupation

Coverage Information

Currently Insured?

Yes No

Current Insurance Company

Current Insurance Policy Expiration

Current Policy Coverage

# Claims in Past 5 Years

Additional Desired Coverage

Appliance Breakdown Earthquake Flood Identity Theft Jewelry

Dog?

Yes No

What Breed?

Condo Information

Property to Insure ✶

Same Address as Above Different Address than Above

Street Address ✶

City ✶

State ✶

ZIP Code

Year Built

Type

Stories

Living Space

sq ft

Construction

Foundation

Age of Electric

years

Age of Plumbing

years

Age of Heating

years

Deck?

Yes No

Deck Size

sq ft

Screened-In Porch?

Yes No

Porch Size

sq ft

Security System?

Yes No

Anything Else?

Comments

Binding Agreement

I was referred by a RE/MAX Unlimited agent

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