Insurance Election Agreement
Please complete this form to select an insurance policy to cover your belongings while they are in storage.
Please select the policy that is right for you. *
First Name & Last Name *
Your answer
Address + City + State + Zip *
Your answer
Phone *
Your answer
Email *
Your answer
I understand that the policy I have chosen will be automatically included in my amount due monthly. *
Required
My name below serves as my signature indicating my election of the insurance coverage selected above. *
Your answer
Today's date *
MM
/
DD
/
YYYY
Time
:
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