Need to talk? Call (801) 505-5500

Team member filling out for client

Private Client Insurance Application

Tell us about your household and assets. Your advisor will build a program tailored to you.

Auto-saves every 30 seconds

Household

Coverage

Details

Review

Step 1: Your Household

Primary Contact

First Name *

Last Name *

Email *

Phone *

Date of Birth *

Marital Status

Spouse / Partner

First Name

Last Name

Date of Birth

Occupation

Current / Mailing Address

Where you live right now. If you are moving, enter your current address here - you will enter the new property address later.

Street Address *

City *

State *

ZIP Code *

Current Insurance

Current Carrier

Knowing your current carrier helps us identify the best fit

Policy Expiration

Desired Effective Date

What brings you to Grit?

Household Profile

We ask these ranges to match you with the right carrier program. Private client carriers have eligibility thresholds. Skip these if you prefer to discuss on a call.

Household Income Range

Total Property Value (all properties)

Claims History

Any claims in the past 5 years?

Yes No

Describe claims (dates, type, approximate amount)

Any cancellations or non-renewals in the past 5 years?

Yes No

Describe

Step 2: What Needs Coverage?

Private client programs deliver the best rates and broadest coverage when all your policies are placed together.

Select everything you need covered - even lines you are not sure about - and we will build the right program.

Primary Residence Additional Properties Auto & Collector Vehicles Valuable Collections Watercraft Umbrella / Excess Liability Domestic Staff Cyber & Identity Protection

Step 3: Details

Upload current dec pages if you have them. Share what you can below - your advisor will walk through the rest with you.

Primary Residence

Have your current homeowners dec page?

Upload it here - we can pull most of what we need.

Share what you can. Your advisor will walk through the rest with you.

Is this a new home purchase or are you moving?

Yes - I am buying or moving to a new home No - this is my current home

Your current address is captured in Step 1. Enter the address of the home you are purchasing or moving to below.

Closing Date

Need coverage on your current home during the transition?

Property Address

The address of the home you want insured. If you are moving, this is the new property.

Street Address

City

State

ZIP

Property Details

Year Built

Square Footage

Stories

Construction

Roof Type

Heating

Bedrooms

Bathrooms

Garage

Replacement Cost

Not market value - what it would cost to rebuild to the same standard. If you do not know, leave blank and we will help estimate.

Estimated Replacement Cost ($)

Contents Value ($)

Home Updates

Approximate year is fine. Leave blank if original or not sure.

Roof

Electrical

Plumbing

HVAC

Custom Features

Check all that apply. These affect replacement cost and coverage.

Wine Cellar Home Theater Smart Home System Whole-Home Generator Pool / Spa Pool House / Cabana Outdoor Kitchen Elevator Guest House Sport Court / Tennis Barn / Equestrian Dock / Boat Lift

Swimming Pool?

Yes No

Pool Type

Fenced?

Security

Monitored Alarm Security Cameras Gated Community Safe Room / Vault Fire Sprinklers Security Staff

Preferred Deductible

Wildfire Risk Area?

Home-based business?

Yes No

Describe the business

Additional structures on property?

Yes No

Describe structures and estimated values

Additional Properties

Have dec pages for additional properties?

Upload it here - we can pull most of what we need.

Upload one or more - we will sort them out.

Tell us about each additional property.

How many additional properties?

Property 1

Property Address

City

State

ZIP

Property Type

Year Built

Square Footage

Construction

Replacement Cost ($)

Occupancy

Property 2

Property Address

City

State

ZIP

Property Type

Year Built

Square Footage

Construction

Replacement Cost ($)

Occupancy

Property 3

Property Address

City

State

ZIP

Property Type

Year Built

Square Footage

Construction

Replacement Cost ($)

Occupancy

Property 4

Property Address

City

State

ZIP

Property Type

Year Built

Square Footage

Construction

Replacement Cost ($)

Occupancy

Auto & Collector Vehicles

Have your current auto dec page?

Upload it here - we can pull most of what we need.

Upload it and we will pull vehicle details. We still need driver information below.

Policy-Wide Coverage Preferences

These apply to all vehicles on the policy. If you are not sure, select "Not sure" and we will recommend.

Liability Limits

UM/UIM will match these limits automatically

Comp / Collision Deductible

OEM Parts Endorsement

OEM = Original Equipment Manufacturer parts

Drivers

List all household members age 15+ who drive. We need this even with a dec page upload.

How many drivers?

Driver 1

First Name

Last Name

Date of Birth

License Number

License State

Violations (past 5 years)

At-fault Accidents (past 5 years)

Driver 2

First Name

Last Name

Date of Birth

License Number

License State

Violations (past 5 years)

At-fault Accidents (past 5 years)

Driver 3

First Name

Last Name

Date of Birth

License Number

License State

Violations (past 5 years)

At-fault Accidents (past 5 years)

Driver 4

First Name

Last Name

Date of Birth

License Number

License State

Violations (past 5 years)

At-fault Accidents (past 5 years)

Driver 5

First Name

Last Name

Date of Birth

License Number

License State

Violations (past 5 years)

At-fault Accidents (past 5 years)

Driver 6

First Name

Last Name

Date of Birth

License Number

License State

Violations (past 5 years)

At-fault Accidents (past 5 years)

Daily Driver Vehicles

Standard daily-use vehicles. Comp and collision choices are per-vehicle. Liability is automatic on every vehicle.

How many daily driver vehicles?

Vehicle 1

Year

Make

Model

VIN

Primary Use

Annual Miles

Ownership

Comprehensive Coverage

Covers theft, weather, fire, glass, animal damage

Collision Coverage

Covers damage from accidents with other vehicles or objects

Vehicle 2

Year

Make

Model

VIN

Primary Use

Annual Miles

Ownership

Comprehensive Coverage

Covers theft, weather, fire, glass, animal damage

Collision Coverage

Covers damage from accidents with other vehicles or objects

Vehicle 3

Year

Make

Model

VIN

Primary Use

Annual Miles

Ownership

Comprehensive Coverage

Covers theft, weather, fire, glass, animal damage

Collision Coverage

Covers damage from accidents with other vehicles or objects

Vehicle 4

Year

Make

Model

VIN

Primary Use

Annual Miles

Ownership

Comprehensive Coverage

Covers theft, weather, fire, glass, animal damage

Collision Coverage

Covers damage from accidents with other vehicles or objects

Vehicle 5

Year

Make

Model

VIN

Primary Use

Annual Miles

Ownership

Comprehensive Coverage

Covers theft, weather, fire, glass, animal damage

Collision Coverage

Covers damage from accidents with other vehicles or objects

Vehicle 6

Year

Make

Model

VIN

Primary Use

Annual Miles

Ownership

Comprehensive Coverage

Covers theft, weather, fire, glass, animal damage

Collision Coverage

Covers damage from accidents with other vehicles or objects

Collector & Exotic Vehicles

Classic, exotic, or high-value vehicles requiring agreed value coverage.

How many collector / exotic vehicles?

Collector Vehicle 1

Year

Make

Model

VIN

Agreed Value ($)

What you and the carrier agree the vehicle is worth

Annual Miles

Storage

Condition

Used for shows or events?

Collector Vehicle 2

Year

Make

Model

VIN

Agreed Value ($)

What you and the carrier agree the vehicle is worth

Annual Miles

Storage

Condition

Used for shows or events?

Collector Vehicle 3

Year

Make

Model

VIN

Agreed Value ($)

What you and the carrier agree the vehicle is worth

Annual Miles

Storage

Condition

Used for shows or events?

Collector Vehicle 4

Year

Make

Model

VIN

Agreed Value ($)

What you and the carrier agree the vehicle is worth

Annual Miles

Storage

Condition

Used for shows or events?

Collector Vehicle 5

Year

Make

Model

VIN

Agreed Value ($)

What you and the carrier agree the vehicle is worth

Annual Miles

Storage

Condition

Used for shows or events?

Collector Vehicle 6

Year

Make

Model

VIN

Agreed Value ($)

What you and the carrier agree the vehicle is worth

Annual Miles

Storage

Condition

Used for shows or events?

Valuable Collections

Have appraisals or collection inventories?

Upload it here - we can pull most of what we need.

Upload appraisals, spreadsheets, or photos. Items over $25,000 should be scheduled individually.

Check each category you own and enter approximate total values. We will work through scheduling details together.

Jewelry Fine Art Wine Firearms Watches Musical Instruments Antiques / Collectibles Other

Jewelry - Total Value ($)

Last Appraisal Date

Fine Art - Total Value ($)

Last Appraisal Date

Wine - Total Value ($)

Storage

Firearms - Total Value ($)

Storage

Watches - Total Value ($)

Musical Instruments - Total Value ($)

Antiques / Collectibles - Total Value ($)

Describe Collection

Total Value ($)

Watercraft

Have your current watercraft policy dec page?

Upload it here - we can pull most of what we need.

Tell us about each vessel.

How many vessels?

Vessel 1

Year

Make

Model

Type

Length (ft)

Estimated Value ($)

Captain / Crew?

Storage

Navigation Area

Vessel 2

Year

Make

Model

Type

Length (ft)

Estimated Value ($)

Captain / Crew?

Storage

Navigation Area

Vessel 3

Year

Make

Model

Type

Length (ft)

Estimated Value ($)

Captain / Crew?

Storage

Navigation Area

Umbrella / Excess Liability

Have your current umbrella policy dec page?

Upload it here - we can pull most of what we need.

Desired Umbrella Limit

Exposure Profile

These questions help us size the right umbrella for your situation.

Number of rental properties

Total vehicles (all types)

Serve on any boards? (nonprofit, corporate, HOA)

Public figure or high-profile occupation?

Own a business?

Social media presence

Domestic Staff

If you employ household staff, they may need workers compensation coverage.

Do you employ domestic staff?

Yes No

Check all that apply.

Housekeeper / Maid Nanny / Au Pair Groundskeeper / Gardener Personal Assistant Chef / Cook Security Caretaker / Property Manager Driver / Chauffeur

Total number of employees

Current workers comp carrier

Cyber & Identity Protection

High-net-worth households are increasingly targeted. Most private client carriers include this or offer it as an endorsement.

Online banking / investment accounts?

Smart home devices? (cameras, locks, thermostats)

Previous identity theft or cyber incident?

Social media presence

Step 4: Review and Submit

Additional Documents

Upload appraisals, dec pages, driver lists, collection inventories, or anything else that helps.

Drag files here or click to upload

PDF, JPG, PNG, XLSX accepted

Anything else we should know?

Preferred Advisor (optional)

I authorize Grit Insurance Group to use this information to obtain insurance quotes on my behalf. I understand this does not constitute the purchase of insurance and that all coverage is subject to underwriting approval.

By submitting this application, you confirm that the information provided is accurate to the best of your knowledge. Grit Insurance Group will use this information solely for the purpose of obtaining insurance quotes. This application does not bind coverage. All policies are subject to underwriting review and approval by the issuing carrier.

Application Received

We have your information and will be in touch shortly to begin building your program.

Expect a personal call within 1 business day.

Questions? Call us at (801) 505-5500

gritinsurance.com | (801) 505-5500 | Salt Lake City, UT | Park City, UT | Challis, ID