16. Has any member of your firm been involved in asset or property preservation servic es including any incidental repair work on
bank owned properties within the last 3 year period? Yes No
17. Has any member of your firm been involved in property rehabilitation services on bank owned properties within the last 3 year
period? Yes No
If Yes to question 16 or 17, were all such repairs contracted by you done by a licensed contractor? Yes No
18. For any bank owned properties where you represent the buyer, do you advise the buyer in writing to have the property
inspected by a licensed and insured home inspector prior to purchase? Yes No
19. Has any member of your firm engaged in acquiring the properties or deeds of financially distressed homeowners, including
sale – leaseback agreements within the last 3 year period? Yes No N/A
20. Has the applicant engaged in any eviction services on pre-foreclosed or bank owned properties within the last
3 years? Yes No
If Yes, was the preparation, filing and service of the eviction complaint and obtaining the eviction judgment
handled by an attorney? Yes No
21. Is any client responsible for more than 25% of the applicant’s annual income? Yes No
If Yes, provide the name, relationship and total revenue from the client.
22. Does the firm perform or intend to perform professional services for REITS or property syndications? Yes No
If Yes, what is the percentage of the gross commission income derived from these services? _____%
23. During the past 5 years:
a. Has the applicant been involved in any merger, acquisition, or consolidation? Yes No
If Yes, provide details on a separate sheet and include any name changes for the firm.
b. Has any principal, partner, director, officer, or professional of the applicant performed professional services for any other
business which the applicant has any ownership or managerial interest? Yes No
If Yes, provide details on a separate sheet.
24. Does the applicant transact business in multiple states or outside of the United States? Yes No
If Yes, provide details on a separate sheet, including the percent (%) of total gross revenues from each state or country.
25. After inquiry, is the applicant, or anyone to whom this insurance will apply, aware of any:
a. Professional Liability claim made against them in the past 5 years? Yes No
b. Act or omissions in the performance of professional service for others which might reasonably be expected to be the
basis of a claim or suit against them? Yes No
c. Complaint, disciplinary action or investigation by any regulatory authority? Yes No
d. Changes in any claims previously reported on past applications? Yes No
IMPORTANT NOTE: The applicant’s disclosure of claim information does not indicate nor imply, in any way, that any act or omission is
covered by this policy. In addition, circumstances or incidents that might reasonably be expected to be the basis of a claim MUST be
reported to the applicant’s current insurer before the claim reporting period expires.