Homeowner’s Insurance Quote – Richards Insurance Agency

You may use the form below to request a free homeowner’s insurance quote online. Alternatively, you may contact us if you have any questions or would like to request a quote by phone or in person!

*First Name:

*Last Name:

SSN:

Social Security Number Information
Why are we asking for your social security number?
Many insurance companies include an insurance credit score, based on formulas weighting different credit factors from your credit report. Supplying your Social Security Number will help assure that the right credit record is used and that any premium estimate is accurate.

*Phone:

*Physical Address:

PO Box Address:

*City:

*State:

*ZIP Code:

Fax:

*Are you insured now?

Reason for changing (if applicable)?:

Year home was built:

*Type of heating:

Any updates within 10 years to:
*Roof?
*Electrical?
*Plumbing?
*Heating?

Total Square Feet:

Stories:

Number of bathrooms:

Number of bedrooms:

Construction of house:

Foundation:

Garage:

Types of Coverages:

*Dwelling Amount:

*Personal Property Amount:

*Outbuilding Coverage:

*Deductible:

*Liability:

*Med Pay: