Questionnaire Text

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C. Answer questions 19-23 only if you or someone else in this household owns or is buying this house, apartment, or mobile home. Otherwise, skip to E on the next page.

21. What is the annual payment for fire, hazard, and flood insurance on this property?

Annual amount: $____.00
or
[] None

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21. When premiums are paid other than on a yearly basis, convert to a yearly basis. Enter the yearly amount even if no payment was made during the past year.