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Customer Homeowner Update Form

As a valued customer of Elliot Whittier, getting you the appropriate insurance coverage at the best possible pricing is paramount to what we do every day.  Please help by taking a moment to complete the following, and return to us ASAP!

Regarding your home that you have insured with us:
* Required fields
#AMPS of electrical system *



Is the electrical system fuses or circuit breakers? *



Is the Heating System... *



Do Any Household Members Smoke? *


Do you or your spouse work less than 20 hours per week? *


 

Call us at 1-800-696-3947
or
Email us at info@elliotwhittier.com

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