Personal Lines Quote Form If you do not have the answer, feel free to skip the question. Personal Lines Quote Step 1 of 5 20% Name First Last Email* Date Of Birth* Date Format: MM slash DD slash YYYY Phone*Marital Status*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Why are you shopping your policy?*Current Carrier?*Copy of your current Insurance If you have itOwn or Rent* Own Rent AUTO QUOTEHow many vehicles are you looking to insure? Please list Year, Make, Model & VINPlease List the names, DOB, DRL# and vehicle for each driver.Are any drivers a "youthful good student" with GPA 3.0 or higher?Are any of these vehicles used in ride sharing dervice such as UBER, Lyft, food delivery or other? If yes, please list. HOME QUOTESquare Footage/ Year Built/ Purchase DateBasement Y/N Finished or UnfinishedGarage Y/N Attached or DetachedHome Updates in last 5 years (Roof/ Electric/ Plumbing/ Heating & Cooling)How Many StoriesNumber of Bathrooms Full/HalfDo you have any Pets, if so what type and breed?Do you have a pool or a Trampoline? If so, please describe type.Describe attached/detached structures such as decks, porches, patiosDo you home share? Airbnb ECTAny Valuables needing to be InsuredJewelry, Gun, Art, Fur, Instruments ECT Preferred Payment MethodMortgagee BillI pay for my home InsuranceCurrent Monthly Payment? RECREATIONAL QUOTEBoat, RV, Golf Cart, Motorcycle,BoatRV/ CamperGolf CartMotorcycleHow did you hear about our agency?Anything else that we should know?