Home Insurance Quote

Home Insurance Quote Application

房子报价申请表
Name 姓名*

First Name Last Name
Date of Birth 出生日期*

MonthDayYear
Date
Additional Applicants on Deed*
Address 地址*

Street Address 街道地址

Street Address Line 2

City 城市State / Province 州

Postal / Zip Code 邮编Country 国家
Is this also the Mailing Address? 以上地址也是邮寄地址吗？

YesNo
Mailing Address 邮寄地址

Street Address 街道地址

Street Address Line 2

City 城市State / Province 州

Postal / Zip Code 邮编Country 国家
Phone Number 电话号码*
E-mail 电子邮箱*
example@example.com
Home Quote Type: 房报价种类
Is the home financed? 房子有贷款吗？

YesNo
Is it new purchase? 是新买的房子吗？

NoYes
If Yes, the closing date is? 如果是的话，过户日期是？

MonthDayYear
Date
Prior Insurance Information 之前的保险信息
Number of Bedrooms 房间数1
Number of Baths 卫生间数
Pool? 有游泳池吗？

YesNo
If Yes, Pool Sq. Ft.? 如果有的话，游泳池面积？
Is the yard Fenced? 后院有围起来吗？

YesNo
Smokers? 有烟雾感应器吗？

YesNo
HOA? 有管理费吗？

YesNo
Age of Roof 屋顶几年新？
Garage (# of Cars) 车库可以放几辆车？
Enter 0 if no Garage...
Updates to Electrical, Plumbing, or A/C? 电线、水管或冷暖系统有更新吗？
Please list and provide approximate month/year of update for each. 请详细列出更新的月份/年份。
Claims in last 5 years? 5年内有过理赔吗？
Describe what type and how much was paid. 请描述是什么种类的理赔和赔付的金额。
Additional Notes
Insurance Generation Agency

Auto | Home | Umbrella | Commercial | Life | Health

Tel: (650) 488-1690

Fax: (650) 360-1088

Email: quote@iga.agency

Website: https://iga.agency

Wechat QR code
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Home Insurance Quote Application