Homeowners Intake

Get a Homeowners Quote

Here's How This Works
Thank you for considering Sumners Insurance Agency for your Homeowners insurance needs!

We need all of the information requested in this form to confidently advise you, and may have additional questions after submission. This form will not generate instant quotes; an agent will review the submission and fit it with one or more appropriate insurance companies we represent

We don't increase or decrease rates to play a price game. Rates are determined by insurance companies and approved by the department of insurance. The price is determined by the amount of coverage, which is is your decision, and the unique underwriting characteristics of you and the home, which are out of our control.

We request current/prior insurance information, including price, as a necessary step in evaluating whether we can provide you with the protection you need.

Requesting a homeowners quote does not commit you to purchasing any insurance from us. We appreciate your time spent reaching out to us.
Select the state where your home is:*

IowaMinnesotaWisconsinNebraskaArizona (secondary home only)
Before You Begin

Information to Collect
Gather information about the home, especially update (renovation/replacement) information for:
- Roof
- Furnace
- Plumbing
- Electrical
- Siding
- Other items
If you already have insurance on the home for which you're requesting a quote, you will be required to upload the current declarations page (policy) showing coverage and premium.

Also included on the form are questions about the home's mortgage, prior claims, your spouse or significant other, and potential risk characteristics.

Ready? Click Next to Start!

Information About You

Hello, there!
Primary Insured*

First NameLast Name
Phone Number*
Please enter a valid mobile number.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Physical Address*

Street Address

Street Address Line 2

CityState

Zip Code
Mailing address is different

Yes
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have a spouse or live with another adult?

Yes
Select all that apply about the other adult(s) in your household:*

SpouseBoyfriend/GirlfriendTheir name is, or will be, on the deed/title of homeI want coverage for their belongings, tooRelated by blood or adoption
Second Person*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid mobile number.

Mortgagee Information

If you have a loan on your home
Do/will you have a mortgage or other loan on the home?*

YesNo
Will your insurance premium be escrowed?*

YesNoI Don't Know
Name of bank or lender:*
Address of bank or lender:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If available, provide contact information for your lender
We will use this to send them proof of insurance
Loan Number
Optional

Preferences

Insurance Your Way
Which payment options work for you?*

AnnuallyQuarterlyMonthly by checkMonthly via automatic bank EFT
How would you prefer to receive policy and billing correspondence?*

Electronically (app, website, email)Paper (mail - additional costs may apply)
Don't worry - we don't spam you or give away your number, but we have found text messaging is very convenient for our clients. May we text you?*

YesNo

Current/Prior Insurance Declarations Page

Required if you answered "Yes" to having current/prior insurance on the home
Cancelof
Townhome/Condo Codes, Covenants, Restrictions (CCR's)

Cancelof
Interior Photos (Optional)

Cancelof
Take Photo
Should be Empty:

Get a Homeowners Quote

Before You Begin

Information About You

Eligibility

Eligibility Continued

Updates

Mortgagee Information

Preferences