[FIRSTNAME] - First Name

[MIDDLENAME] - Middle Name

[LASTNAME] - Last Name

[ADDRESS1] - Insured Address 1

[ADDRESS2] - Insured Address 2

[APARTMENTNUM] - Apartment Number

[CITY] - City

[COUNTY] - County

[STATE] - State

[ZIPCODE] - ZIP Code

[EMAILADDRESS] - Email Address

[HOMEPHONE] - Home Phone

[CELLPHONE] - Cell Phone

[WORKPHONE] - Work Phone

[WORKEXT] - Work Phone Ext

[EFFDATE] - Policy Effective Date

[EXPDATE] - Policy Expiration Date

[ADDITIONALINSURED] - Additional Insured

[LEADSOURCE] - Lead Source

[QUOTEDESCRIPTION] - Quote Description

[DOB] - Insured Date of Birth

   [AGE] - Age

[LEGALDESCRIPTION] - Legal Description

[OCCUPANCY] - Occupancy

[DWELLINGUSE] - Dwelling Use

[USAGETYPE] - Usage Type

[CONSTRUCTION] - Construction

[ROOFCOMPOSITION] - Roof Composition

[PURCHASEDATE] - Purchase Date

[PURCHASEPRICE] - Purchase Price

[YEAROFCONSTRUCTION] - Year of Construction

[NOADDLRESIDENCES] - No. of Addl. Residences

[SQFOOTAGE] - Sq. Footage

[MILESFIRESTATION] - Miles to nearest fire station

[FEETTOHYDRANT] - Feet to nearest hydrant

[CITYLIMITS] - City Limits

[HAILRESISTANTROOF] - Hail Resistant Roof

[NUMBEROFSTORIES] - Number of Stories

[PROTECTIONCLASS] - Protection Class

[HEATINGUPDATE] - Heating Update

[YEARHEATINGUPDATE] - Year Updated

[ELECTRICALUPDATE] - Electrical Update

[YEARELECTRICALUPDATE] - Year Updated

[ROOFINGUPDATE] - Roofing Update

[YEARROOFINGUPDATE] - Year Updated

[PLUMBINGUPDATE] - Plumnbing Update

[YEARPLUMBINGUPDATE] - Year Updated

[HEATINGTYPE] - Heating Type

[WOODBURNINGSTOVE] - Wood Burning Stove

[SWIMMINGPOOL] - Swimming Pool

[TRAMPOLINEONPREMISE] - Trampoline on Premise

[DWELLINGFORM] - Form

[DWELLINGLIMIT] - Dwelling Limit

[CONTENTLIMIT] - Contents Limit

[OTHERSTRUCTURESLIMIT] - Other Structures Limit

[LOSSOFUSELIMIT] - Loss of Use Limit

[HOLIABILITYLIMIT] - Liability Limit

[HOMEDICALPAYMENTSLIMIT] - Medical Payments Limit

[DEDUCTIBLE1WINDHAIL] - Deductible #1 (Wind/Hail)

[DEDUCTIBLE2ALLOTHER] - Deductible #2 (All Other)

[DEDUCTIBLE3] - Deductible #3

[BILLMORTGAGEE] - Bill Mortgagee

[FIRSTMORTGAGEE] - First Mortgagee Name

[FIRSTMORTGAGEEADDRESS] - First Mortgagee Address

[FIRSTMORTGAGEECITY] - First Mortgagee City

[FIRSTMORTGAGEESTATE] - First Mortgagee State

[FIRSTMORTGAGEEZIP] - First Mortgagee Zip

[FIRSTMORTGAGEELOAN] - First Mortgagee Loan #

[SECONDMORTGAGEE] - Second Mortgagee Name

[SECONDMORTGAGEEADDRESS] - Second Mortgagee Address

[SECONDMORTGAGEECITY] - Second Mortgagee City

[SECONDMORTGAGEESTATE] - Second Mortgagee State

[SECONDMORTGAGEEZIP] - Second Mortgagee Zip

   [SECONDMORTGAGEELOAN] - Second Mortgagee Loan #

[FIREALARM] - Fire Alarm

[BURGLARALARM] - Burglar Alarm

[DEADBOLTS] - Deadbolts

[SMOKEDETECTORS] - Smoke Detectors

[FIREEXTINGUISHERS] - Fire Extinguishers

[AUTOPOLICY] - Auto Policy