Home Owners Quote Info Sheet

Name:
Phone:
Auto Insurance Co.
Property Address:
City:
Zip/Post. code:
Sq. Footage
Year Built
# of Floors
# of Bedrooms
# of Baths
Roof (what kind)
Laundry room upstairs? Yes No
Water Heater in
Garage 		Yes No
Attached Garage

Yes No

Pool? Yes No
Fireplace? Yes No
Any claims last three years? Yes No
Any Dogs? Yes No
What kind?
Any updates? Yes No
What year?
Electricity
Roof
Plumbing