PERSONAL INSURANCE
PERSONAL INSURANCE TEAM
FREQUENTLY ASKED QUESTIONS
DID YOU KNOW?
Requesting a change on your insurance policy is as
easy as 1,2,3.

Click here to get a policy change form.

Homeowners Insurance Quote

We will provide you with a free, no-obligation quote and the information you provide will be used for this purpose only. Your privacy is important to us. Please provide accurate information so that we may comply with your quote request quickly.

About you:
First name:
Last name:
Contact phone:
Fax:
Email:
Address:
City:
State:
Zip:
Name of your current insurance company:
How long have you been insured with that company?
Prior claims? yes   no

If yes, describe in detail:
 
About your house:
If new location, please provide address
Distance to fire hydrant: (in feet)
Distance to nearest responding fire department: (in miles)
 
Type of residence:
Do you reside in this property: yes no
Year built:
Smoke alarms: yes no
Fire extinguisher: yes no
Central station alarm: yes no
Dead bolts: yes no
Inside city limits: yes no
 
Total living area: not including: breezeways, decks, porches, balconies, basements, and garages.
(appx. square feet)
Total stories
Primary exterior wall type
Foundation type
Percentage of living space located on ground floor
Heating and cooling system
Fireplaces
Chimneys
Garage type
# of cars for garage
# of full bathrooms
# of half bathrooms
# of screened porches
Do you own animals or pets? yes    no
If yes, please specify here:
Plumbing type:
Circuit breakers or fuses?
Any special features?
 
Coverages:
Dwelling coverage: $
Liability coverage: $
Contents: $
Deductible:   
 
Comments:

How did you hear about our agency?
First Financial
Bank Letter
 Phone Book
Friend or
Relative
 Other
 
Thank you for requesting a quote. We will get back to you with
your free, no-obligation quote as soon as possible.

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