Please review the list of items below and check all those that apply to you or that might apply in the
next 12 months. This checklist will identify additional ways that we may be able to help you save money
or identify insurance needs that are not currently being met. Feel free to add additional comments or questions. When finished, click the “Send My Check-Up to MLI” button to have your personal insurance check-up automatically sent to the professional and caring insurance agents at Mountain Lakes Insurance.

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AUTO
I have a home insured with another company.
A household driver has recently or plans to complete a defensive driving course.
Household drivers have or will soon change.
My vehicle use has changed.
My car loan has recently or will soon be paid off.
I'm considering the purchase or lease of a new vehicle in the next 12 months.
I have children at or nearing driving age.
I've purchased or am considering purchasing a boat, motorcycle, RV or other recreational vehicle.
I don't understand all of my auto insurance coverages or needs.

HOME
I have auto insurance with another company.
I recently installed or plan to install a security system in my home.
I recently remodeled, put an addition on or completed home improvements. (or plan to)
I have changed the use of my home (e.g., from primary to secondary or rental property)
I have rental or investment property insurance with another company.
I'm operating a business from or work out of my home.
I'm considering the purchase of a new home in the next 12 months.
I own valuable jewelry, collectibles, antiques, guns or sporting equipment that are not scheduled.
I would like information about flood insurance.
I don't understand all of my home or property insurance coverages or needs.

OTHER
My assets have or will change significantly.
I don't have any or enough life insurance at this time.
I have questions about annuities, disability insurance and/or long-term care insurance.
I would like information about personal umbrella coverage.
I would like information about business insurance.

COMMENTS

I do not have any questions or needs regarding my insurance coverages at this time.

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We are proud to offer protection to meet your needs from high quality insurance companies like:
Auto Owners, Travelers, Hartford, Safeco, Progressive, Foremost, ASI, Dairyland,
Encompass, and others.