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Zip Code of Home
First Name
Last Name
Home Phone
Date of Birth
Use of unit (primary residence, rental, etc.)
How much did you purchase the home for?
Purchase Date
Model Year of Home
Size of Home
Make of Home
Is home on concrete slab?
Is it tied down?
Are you the original owner of home?
Do you own the land where the home is?
Is it in a park or private property?
Is there a shingle or metal roof on home?
Is the siding vinyl or metal on the home?
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