Please fill out the form as completely as possible. A representative from L&M Insurance will call back with information about your home insurance Homeowners Quick Quote FormFirst Name * Last Name * Date of Birth? Address * City * State * Zip * Primary Phone Number * E-mail Address * How did you find out about us? Is this property, or will this property, be purchased in your personal name? *YesNo Describe the name or entity you will be purchasing the home in ex: family trust, land trust, LLC, corporation. Are you currently insured? *YesNo What is the name of your current insurance company? When does the policy renew? Is this property a new purchase? *YesNo Will you be living in the home or renting it out? LivingRenting Is the property occupied? YesNo Where are you currently residing? Current State Current City Current Zip When will property be occupied? Will you or your tenant occupy the home year round or seasonal? When did you last have insurance on the property? Why is it not insured? When is the approximate date of your closing? Is this home purchase a foreclosure or short sale home? YesNo Is this property in a gated community? YesNo Check all that apply Is there a 24-hour guard?Is there only one entrance into the community?Is there a pass key or barcode reader at each entrance?Is there a 24-patrol within the community? What year was your home built? Is the home one or two-story? 12 Describe what is upstairs Is the exterior stucco and paint? YesNo Any homeowners claims in the last 3 years? YesNo Briefly describe the claim, the date the claim occurred and the amount paid. Do you have a pool? YesNo Is it above or below ground? Above groundBelow Ground Click all that apply Is it fenced (at least 4 feet high) and gated or screened?Is there a slide?Is there a diving board? Do you or your tenant have any animals? YesNo Describe the animals. If mixed breed, describe all breeds animal is mixed with. Does this home have a MONITORED alarm system? YesNo Monitored for fire? YesNo Monitored for burglary? YesNo Roof type ShingleMetalTile Is this the original roof? YesNo When was the roof last replaced? What is the heated square footage of your home? Number of bedrooms? Number of bathrooms? Do you have a garage? YesNo How many cars will your garage hold? Message VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank L&M Insurance proudly provides free Homeowners Insurance Quotes in Brandon, Tampa and all of Florida.
