The renters insurance questionnaire has to be filled by an applicant who is basically applying for renters insurance. Renters insurance can be a part of an umbrella policy or a standalone basic policy. The renters insurance questionnaire comprises of basic questions that throw light on what an applicant wants to insure and how it will benefit them.

Sample Renters Insurance Questionnaire:

Name of the Applicant: _________________

Address: _____________________________ State: ________  Zip: _________

Phone Number: ______________

Email Address: ______________

Social Security #: ______________________________

Number of Rooms in the house:________  Year built: ________

Q1.  Which of the following do you keep in your home?

  • Jewelry
  • Electronics
  • Computers
  • Firearms
  • Inflammable items
  • Rare artifacts
  • Others

Q2.  Did you have a renters insurance prior to this? If yes, please provide details

  • Yes
  • No

Previous insurance Number: _________________  Insurance Company:_____________

Q3.  Do you own any of the following pet? Please mention breed

  • Dog
  • Cat
  • Horse
  • Rabbit
  • Turtle
  • Fish
  • Any other pet:__________________

Q4.  Which of the following home security devices have you installed?

  • Deadbolts
  • Fire extinguisher
  • Fire hydrant
  • Fire or smoke alarm
  • Burglar alarm
  • Sprinkler system
  • Security cameras
  • Motion detectors
  • Wireless security systems

Q5.  Which of the following discounts are you eligible for?

  • 24-hour guard credit
  • Age 50 plus credit
  • Senior Citizen credit
  • Gated community credit
  • 2-year claims free credit
  • Local alarm credit

Q6.  How many members stay in the building or your apartment?

  • Single member
  • 1-3 members
  • 3-5 members
  • 5-7 members
  • More than 7 members

Q7. Have you made any recent improvements to your home? Please list the nature of improvements


Q8.  What is the amount of content coverage that you require?


Q9.  What is the amount of liability coverage that you require?