Request Information - Shofner & Associates Insurance

With Staff Offering
Over 165 Years Combined Experience
Specializing in Personal and Professional
Insurance Service For All Your Insurance Needs

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Home Insurance Quote Request

Privacy Statement: The information that you provide will only be used to provide a quote for insurance. It will not be distributed to third parties, unless specifically required to attain an accurate quote. The information will not be sold or used for mass marketing. Please note that we are only licensed to do business in the state of Texas.

* Required Information

* Full Name:

* Address:

* City:

* State:

* Zip:

* Phone Numbers:

Email Address:

* Social Security Number:

* Date of birth:

* Occupation

* Value of Home:

Closing Date:

Mortgage Company:

Year Built:

* Square Footage:

* Foundation:

Slab Pier/Beam

* Exterior:

* Number of stories:

* Garage:

* Carport:

Yes No

* # of baths:

* # of bedrooms:

Basement?

Yes No

* Fireplace?

Yes No

* Pool?

Yes No

* If yes, is pool fenced?

Yes No

Type of roof:

Age of roof?

Is the roof hail resistive?

Yes No

If yes, class:

If home is 20 years old, any updates on wiring, plumbing or heating?

* Amount of coverage:

* Amount of deductible:

Any scheduled items & values

Bicycles:

Furs:

Cameras:

Jewlery:

Coins:

Silverware:

Musical Insruments:

Stamp Collections:

Personal Effects

Fine Arts:

Golfer's Equipment:

Extension of liability to any other property owned?:

* Any claims in the last 5 years?

Yes No

If yes, what type of claim & when was the claim?

Before Trouble Strikes Call...
Texas (806) 792-3261 - New Mexico (575) 437-6331


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