Trust, LLC or Legal Entity Additional Insured Questionnaire

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If you are part of a Trust, LLC or Legal Entity, please fill out the form below. We appreciate your valued business and are here to answer any questions you may have.

Trust, LLC or Legal Entity Additional Insured Questionnaire

Thank you for your interest in Rancho Santa Fe Insurance. Please fill out the following information and one of our agents will contact you shortly. If you have an immediate need, please don't hesitate to call us at 858-756-4444 or email info@rsfinsurance.com.

Name

Phone

Alternate Phone

Your Address

Mailing Address for Trust/LLC (If Different)

Trust/LLC Information

Name of Trust, LLC, or Legal Entity

Quote/Policy Number

What is the Intent of the Trust, LLC, or Legal Entity?

Who are the Members of the Trust, LLC, or Legal Entity?

If More Than One Member, How Are They Related?

Does the Trust, LLC or Legal Entity Operate On A For-Profit Basis?

If Yes, How Are The Profits Generated?

If Yes, What Revenues Does the Trust, LLC or Legal Entity Generate?

What Are The Holding or Assets of the Trust, LLC or Legal Entity?

What Other Activities Does te Trust, LLC or Legal Entity Engage In?

Is There Any Other Insurance Coverage in Place for the Trust, LLC or Legal Entity?

If So, Provide the Carrier Name & Limit

Are There Any Employees of the Trust, LLC or Legal Entity?

If Yes, How Many Employees?

If Yes, What Are Their Responsibilities?

How Are The Paid?

If The Trust, LLC or Legal Entity is to be Added to the Excess Liability Policy, Please List the Interest(s) that the Entity Has in the Client's Home(s) and/or Auto(s).

Name of Person Completing This Form

Comments or Questions

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