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Please enter the mailing address of the home to be insured.
Building Information
Type of Home
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Single Family Home
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Year Built
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Please enter the year this building was constructed.
Construction Type
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Please enter the construction type of the building to be insured.
Foundation
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Bsmt Fully Finished
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Roof Type
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Asphalt Shingle
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Please enter the type of roof. If there are multiple roof types please include that in the comments below.
Roof Age
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5-10 Years
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Please enter the age of the roof. When it was last replaced.
Square Footage
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Please enter the approximate square footage of the home.
Primary Heating
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Gas (Forced Air)
Electric
Hot Water Radiator
Oil/Coal/Karosene
Propane
Stove
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Please enter the primary source of heating in the building to be insured.
Bedrooms
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1
2
3
4
5
6
7+
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Please enter the total number of bedrooms.
Bathrooms
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1
1.5
2
2.5
3
3.5
4+
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Please enter the total number of bathrooms in the home.
Stories
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Please enter the total number of stories in the home.
Garage Type
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Please enter the type of garage if one exists on the premises.
Is this a new purchase?
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Yes
No
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Have you had 2 or more home claims in the last 5 years?
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Yes
No
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Select any additional property features that apply.
*
Dead Bolts
Fire Extinguishers
Trampoline
Covered Deck/Patio
Swimming Pool
Please select all that apply.
Is your home located in a flood plain?
*
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Yes
No
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If you're not sure please include that in the comments below.
Security System
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None
Monitored
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Please enter the type of security system in the home.
Municipal Location
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Inside City Limits
Outside City Limits
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Please enter whether the home is located within the local city limits. If you're not sure please include that in the comments below.
Fire Alarm
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Please select the type of fire alarms that currently exist in the home.
Do you have any of the following breeds of dogs: Chow, Doberman, German Shepherd, Pit Bull, Rottweiler, Wolf Hybrid, or a mix of these?
*
-
Yes
No
Not Sure
Failure to answer this question truthfully can result in a denied insurance claim.
Do you have knowledge of your dog biting anyone?
*
-
Yes
No
Not Sure
Policy Information
Approximate Replacement Cost of Dwelling (not including land)
*
How much do you think it would cost to rebuild your home from the ground up?
Personal Liability Coverage Desired
*
Standard Coverage
Premium Coverage
Minimum Coverage
Other
Not Sure
Liability coverage pays other people for losses they suffer that you could be sued for.
Desired Deductible
*
$500
$1000
$2000
Other
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The deductible is the amount of money the homeowner needs to pay before the insurance company will pay for any claim.
When would you like this policy to start?
*
Please enter the date you’d like this new policy to go into effect.
Have you reported any claims or losses to your insurance company within the past 5 years?
*
-
Yes
No
Not Sure
Please include details in the comments below if you answer yes to this question.
Will this insurance replace an existing policy?
*
-
Yes
No
Not Sure
Do you currently have home insurance for this building?
Credit Rating
*
Excellent
Good
Poor
Not Sure
Please select your approximate credit rating.
Additional Comments?
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Please let us know if there's anything else we should know to provide you an accurate insurance quote.
In order to offer you accurate quotes and additional insurance products that may meet your protection needs, we will use the information collected from you and other sources, such as driving records, claims and credit history where permitted by law. The information will be used in accordance with our privacy policy located on answerfinancial.com. By seeking a quote, you agree to this collection and use of information.
*
I have read the disclosure statement above to the applicant.
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Your private information is provided exclusively to our agency and will not be redistributed or sold to anyone else.
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Contact Information
*
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Name
*
First
Last
Please enter your first and last name
Email
*
Please enter an email address we can use to contact you about this insurance quote.
Phone Number
*
Please enter a phone number we can use to contact you about this insurance quote.
Home Owner
*
-
Yes
No
Marital status
*
-
Married
Single
Divorced
Separated Widowed
Date of Birth MM/DD/YR
*
Number of years continuously insured
*
-
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20+
Length with current insurance company
*
Claims in the last 3 years
*
-
0
1
2
3
4
5
6
7
8
9
10
Tickets in the past 3 years
*
-
0
1
2
3
4
5
6
7
8
9
10
Number of times Used roadside assistance in the last year
*
-
0-2
2-5
5
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Please enter the mailing address of the home to be insured.
Additional Comments?
*
Please let us know if there's anything else we should know to provide you an accurate insurance quote.
In order to offer you accurate quotes and additional insurance products that may meet your protection needs, we will use the information collected from you and other sources, such as driving records, claims and credit history where permitted by law. The information will be used in accordance with our privacy policy located on answerfinancial.com. By seeking a quote, you agree to this collection and use of information.
*
I have read the disclosure statement above to the applicant.
🔒 Your information is secure.
Your private information is provided exclusively to our agency and will not be redistributed or sold to anyone else.
Get QUOTE
Home
Quotes
Quote and Buy Online
>
Property
>
Home Insurance
Auto Insurance
Renters Insurance
Business
>
Business Owners Package (BOP) Insurance
Commercial General Liability Insurance
Short-Term General Liability
Life
>
Term Life Only
Term Life (No Exam)
Whole Life (No Exam)
Life Insurance with living benefits
Calculate your Life Insurance
Health
>
Health Insurance
Critical Illness Insurance Quote
Dental Insurance
Disability Insurance
Vision Insurance
Other
>
Food Liability
Independent Beauty Professional
Trade Show
Travel Insurance
Have A Consultation With An Agent
>
Property Quotes
>
Home Insurance Quote
Flood Insurance Quote
Landlords Insurance Quote
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Business Insurance
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Burial Policy Quote
Health Quotes
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Employee Group Benefits Quote
Long Term Care Insurance Quote
Other Quotes
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Event Insurance Quote
Umbrella Insurance Quote
Service
Report a Claim
Update Contact Info
Financial Education
Financial Coaching
Policy Changes
Proof of Insurance
Policy Review
Contact My Carrier
Online Documents
Free Consultation
Insurance
Life/Financial
>
Life Insurance
Term Life Insurance
Whole Life Insurance
Annuities
Guaranteed Issue Whole Life
Disability Insurance
Burial Policy
Financial Planning
Health
>
Health Insurance
Dental Insurance
Long Term Care Insurance
Vision Insurance
Property
>
Home Insurance
Flood Insurance
Landlords Insurance
Renters Insurance
Vehicles
>
Auto Insurance
ATV Insurance
Motorcycle Insurance
RV Insurance
Business
>
Business Insurance
Business Owners Package (BOP) Insurance
General Liability
Commercial General Liability
Short Term General Liability
Group Benefits
Insurance Bonds
Other
>
Event Insurance
Food Liability
Independent Beauty Professional
Trade Show
Umbrella Insurance
About
Staff Directory
Client Testimonials
Refer a Friend
Accessibility Statement
Join Our Team
America Saves Pledge
Life Insurance Awareness Month
Start Your Own Agency
Insurance Carriers
Our Store
News
Blog
Schedule a Consultation
Book an Appointment