Section 13, Part B.1 collects detailed information about homeowner's insurance policies reported in Part A.2.
For definitions Information Booklet »
What is the name of the insurance company for "your (1st, 2nd, 3rd)"
homeowner's policy? [enter text] ____________________
* Enter name of insurance company, not the insurance agent.
Briefly describe the policy.
[enter text] ______________
Which property(ies) does/did this policy cover?
[enter text] ____________________
* Enter number of each property covered, separate with commas.
Are the policy premiums paid -
- Entirely by you or your CU?
- Partially by you or your CU and partially by someone outside your CU?
- Entirely by an employer or union?
- Entirely by another group or persons outside your CU?
Are any premiums paid through payroll deductions?
- Yes
- No
How often are premiums on this policy paid?
-
Weekly
- Biweekly
- Monthly - directly
- Monthly - in mortgage payment
- Quarterly
- Semiannually
- Annually
- Paid-up policy
- Other - Specify
* Specify: [enter text] ___________
Since the first of the reference month,
what was your or your CU total expense for this insurance policy?
[enter value] ______________
* Enter the actual amount the CU paid. Do not include any expenses paid for the CU
by others
How much was paid this month?
[enter value] ______________
* Enter 'C' for a combined expense
-
C
- Not combined expense
What other type of policy is the "long term care insurance" combined with?
* Enter all that apply, separate with commas
- Long term care insurance
-
Life insurance or other policies which provide benefits in case of death or disability
-
Homeowners insurance which protects your home, furniture, personal effects or other property
against fire, flood, theft, loss or damage
- Tenants' insurance which protects your home, furniture, personal effects or other property
against fire, flood, theft, loss or damage
- Automobile or other vehicle insurance
- Other types of non-health insurance
- Misc. combined (unable to specify/DK)
Which property (ies) does this policy cover?
[enter text] ______________
Do you or any members of your CU have any or make payments for any other "homeowner's insurance" policy?
- Yes
- No
End of Section 13B Homeowner's Insurance
Go to Section 13 Part B.1 - Tenant's Insurance - FOR NEW CONSUMER UNITS ONLY »
Go to Section 14 Part A.1 - Hospitalization and Health Insurance »
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Last Modified Date: November 21, 2006