1. Is your home 40+ years old?………....................................................................................................................... Yes No

2. Is your home 10+ years old and has it undergone a major renovation, an addition, or

    had a major new appliance installed?.................................................................................................................... Yes No

3. Are you the owner of a previously owned home?................................................................................................... Yes No

4. Has it been 10+ years since your entire electrical system has been inspected by a certified electrician?........................ Yes No

5. Do you have dim or flickering lights?..................................................................................................................   Yes No

6. Do you have outlets or switches that are not functioning properly?.......................................................................   Yes No

7. Do you have light bulbs that require replacing more often than usual?...................................................................   Yes No

8. Do you have aluminum wiring in your home?......................................................................................................   Yes No

9. Do you have fuses that have blown or breakers that have tripped in the last year?..................................................  Yes No

10. Are your smoke detectors 10+ years old?........................................................................................................   Yes No

11. Has it been more than 30 days since you last tested your GFCI receptacles?........................................................   Yes No

12. Have you had to replace an electrical appliance due to a malfunction other than age?..............................................  Yes No

SCORE RESULTS:

0-1   YES:    Your home is at low risk for an electrical fire.
2-4    YES:    It is advisable you book a free assessment soon.
5-8    YES:    It is strongly advised that you a book a free electrical assessment soon.
9-12  YES:    It is urgent that you book a free electrical assessment today!