Farm/Ranch/Agribusiness Form
How did you hear about us?
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Farm name (individual or LLC?)
*
Your name:
*
First Name
Last Name
Date of birth
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tell us about your operation! What do you produce and how many acres?
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Any claims in the last 5 years?
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Yes
No
Any business outside of farming and ranching on the location?
Yes
No
Is the property open to the public for hunting, fishing, or other recreational purposes?
Yes
No
Any swimming pools, lakes, beaches, fishing lakes, or ponds open to the public?
Yes
No
Do you have a farm side road stand generating over $5,000 annually?
Yes
No
Do you have any U Pick operations, sales, shows, auctions, or Christmas tree sales on the farm/ranch?
Yes
No
Any custom farming?
Yes
No
Any horse riding lessons?
Yes
No
Do you operate a Dude Ranch or Bed and Breakfast on the farm/ranch?
Yes
No
Do you operate a commercial feedlot?
Yes
No
Do you rent any farm equipment or watercraft to others?
Yes
No
Do you generate energy for farm use such as biomethane, biodiesel, solar or wind?
Yes
No
Is your primary home on the farm?
Yes
No
What all do you need insured?
Barns/Arenas
Equipment (tractors, sprayers, etc)
Farm trucks/trailers
Commodities (cattle, grain, etc)
Farm employee housing
How do you prefer to communicate?
*
Phone call
Text
Email
Any other details:
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Submit
Should be Empty: