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Home Insurance Quote Form
Home Insurance Quote
Please fill in the fields below and submit. A representative will contact you with a quote or questions within 24 hours during the business week. Feel free to call us with any further questions or needs at 502-863-1445.
Name
First
Last
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone
Do you live in this home?
Yes
No
Current Insurance Company:
Year built:
Brick or vinyl siding?
Brick
Vinyl
Basement, Crawl Space or Slab?
Basement
Crawl Space
Slab
Amount of coverage on the dwelling:
Select your deductible:
$250
$500
$1,000
Do you want earthquake coverage?
Yes
No
Any schedule property?
Yes
No
Fire hydrant within 1000 feet?
Yes
No
Miles to nearest fire station?
Please enter a number from
0
to
100
.
Fireplace?
Yes
No
Acres of land:
Any farming?
Yes
No
To offer you an accurate quote in one of The Hockensmith Agency’s underwriting companies, the Hockensmith Agency will collect information from consumer reporting agencies such as driving record and credit history reports. We may use a third party in connection with the development of your insurance score. Do you agree to this?
Yes
No