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Policy Effective (or Settlement) Date *
Usage Type *
Will the property be occupied within 30 days of the policy's effective date? *
Date of Birth *
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Do you need additional coverage for any valuable personal possessions (jewelry, artwork, musical instruments, etc.)? If so, what are their values? *
Claims/Property Loses in Past 5 Years (Please Explain)
Is this a Berkshire Hathaway HomeServices new home purchase? *
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