First Name Last Name Email Company City State/Province Phone Mobile Street Zip Total Insured Value # Buildings Property Type:–None–Vacant Residential with/without extra featuresSingle FamilyMobile HomesMulti-family – 10 units or moreCondominiumsCooperativesRetirement Homes not eligible for exemptionMiscellaneous Residential (migrant camps, boarding homes, etc.)Multi-family – fewer than 10 unitsResidential Common Elements/AreasVacant Commercial – with/without extra featuresStores, one storyMixed use – store and office or store and residential combinationDepartment StoresSupermarketsRegional Shopping CentersCommunity Shopping CentersOffice buildings, non-professional service buildings, one storyOffice buildings, non-professional service buildings, multi-storyProfessional service buildingsAirports (private or commercial), bus terminals, marine terminals, piers, marinasRestaurants, cafeteriasDrive-in RestaurantsFinancial institutions (banks, saving and loan companies, mortgage companies, credit services)Insurance companyRepair service shops (excluding automotive), radio and T.V. repair, refrigeration service, electric repair, laundries, LaundromatsService stationsAuto sales, auto repair and storage, auto service shops, body shops, commercial garages, farm and machinery sales and services, auto rental, marine equipment, trailers and related equipment, mobile home sales, motorcycles, construction vehicle salesParking lots (commercial or patron), mobile home parksWholesale outlets, produce houses, manufacturing outletsFlorists, greenhousesDrive-in theaters, open stadiumsEnclosed theaters, enclosed auditoriumsNightclubs, cocktail lounges, barsBowling alleys, skating rinks, pool halls, enclosed arenasTourist attractions, permanent exhibits, other entertainment facilities, fairgrounds (privately owned)CampsRace tracks (horse, auto, or dog)Golf courses, driving rangesHotels, motelsVacant Industrial – with/without extra featuresLight manufacturing, small equipment manufacturing plants, small machine shops, instrument manufacturing, printing plantsHeavy industrial, heavy equipment manufacturing, large machine shops, foundries, steel fabricating plants, auto or aircraft plantsLumber yards, sawmills, planing millsCanneries, fruit and vegetable, bottlers and brewers, distilleries, wineriesPacking plants, fruit and vegetable packing plants, meat packing plantOther food processing, candy factories, bakeries, potato chip factoriesMineral processing, phosphate processing, cement plants, refineries, clay plants, rock and gravel plantsWarehousing, distribution terminals, trucking terminals, van and storage warehousingOpen storage, new and used building supplies, junk yards, auto wrecking, fuel storage, equipment and material storageImproved agriculturalOrchard groves, citrus, etc.Poultry, bees, tropical fish, rabbits, etc.Dairies, feed lotsOrnamental Misc AgracultureVacant Institutional, with or without extra featuresChurchesPrivate schools and collegesPrivately owned hospitalsHomes for the agedOrphanages, other non-profit or charitable servicesMortuaries, cemeteries, crematoriumsClubs, lodges, union hallsSanitariums, convalescent and rest homesCultural organizations, facilitiesForests, parks, recreational areasPublic county schools – including all property of Board of Public InstructionColleges (non-private)Hospitals (non-private)Counties (other than public schools, colleges, hospitals) including non-municipal governmentState, other than military, forests, parks, recreational areas, colleges, hospitalsFederal, other than military, forests, parks, recreational areas, hospitals, collegesMunicipal, other than parks, recreational areas, colleges, hospitalsLeasehold interests (government-owned property leased by a non-governmental lessee)Utility, gas and electricity, telephone and telegraph, locally assessed railroads, water and sewer service, pipelines, canals, radio/television communicationMining lands, petroleum lands, or gas landsSewage disposal, solid waste, borrow pits, drainage reservoirs, waste land, marsh, sand dunes, swampsOutdoor recreational or parklandAcreage Not Zoned Agricultural SUBMIT