Questionnaire Leaving this questionaire for your information only. True False Please print and complete this questionnaire. Just give your best guess as to the numbers of items. All answers are confidential. Thank you. JanFebMar AprMayJun JulAugSep OctNovDec 12345678910111213141516171819202122232425262728293031 Do a print preview and then print this form at 70%. Yes No You may choose to submit the form by e-mail if you wish. We will then print it and delete the e-mail for your security. You must include a valid phone number for our follow-up phone call. Do you live near the Charlotte/Lake Norman area in North Carolina? * Yes No How detailed an inventory do you want? Are your interested in a photographic inventory? Yes No A video inventory? Yes No A written inventory? Yes No How many square feet is your home/business? How many rooms? How many cabinets total? How many closets? How many drawers to inventory separately? Do you own any jewelry, china, crystal, silver, coins, guns, etc. to individually document? If yes, how many items total? Do you own a collection of musical instruments to video or photograph separately? If yes, how many? Do you want to video or photograph family photographs? How many? Do you have serial numbers and/or receipts for your electronic equipment available? Do you want to video or photograph them? Do you wish to photograph or video your driver's license, insurance policies, social security information, medical information, prescriptions, wills, titles, deeds, contact information on lawyers, insurance agents, doctors, etc.? Yes No If yes, how many documents total to video or photograph? Do you have an attic, basement, storage building, garage, or workshop, to be inventoried? Please list. Easy access? Many items? How detailed? Do you own tools to be documented separately? Yes No Do you have exercise or sports equipment to document separately? Many items? Do you own any house boats, fishing boats, speedboats, trailers, RVs or antique cars to inventory in detail? List. Are you available to be there while we compile the inventory? This is very important! Yes No Would you have time to prepare your home with individual items out, or within easy access, and ready to be inventoried? Yes No Do you want to add your own commentary to the video? True False Do you have antiques or heirlooms to talk about on the video? Yes No Are you also interested in an estate planning video? Yes No Do you think you have adequate replacement cost insurance coverage for most perils? Yes No Do you have flood insurance? Yes No Is there anything else of specific interest that I need to know to better help you? Your name? * Your city? Your phone number? * Your e-mail address? * Copyright: 2006 Digital Inventory Solutions
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