Oh boy. Very wealthy new customer wants significant deductible on...

Oh boy. Very wealthy new customer wants significant deductible on home. Which is fine. But is insisting on the lowest auto liability limits. And is a retired attorney. She knows the risk and is choosing that. And I am in North Carolina - meaning I am legally required to write minimum limits if requested. Does anyone have a sample form their agency uses for clients rejecting the offered higher limits? I have one for flood, etc - but no