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Homeowners Insurance Quote Information Sheet CALIFORNIA ONLY

Please Click on Insurance Categories below for a Free Quote

HOMEOWNERS INSURANCE

Please provide us with the following information for a Homeowners Insurance quote:

*California Only*
Currently Own or Purchasing?	Select Own Purchasing
Primary Residence?	NoYes
If not Primary Is it:	Select Tenant Occupied Secondary Home
Your Current Home Insurance Company:
Current Dwelling Value:
Current Premium:
Current Policy Renewal Date:
If Purchasing, Purchase Price of Home:	*Excluding Land*
Address of Home:
Year Home was Built:
Frame or Masonry?	Select Frame Masonry
How Many Stories?	Select One Two
Type of Roof:
Square Footage of Home:
How Many Bedrooms:
How Many Bathrooms:
Primary Source of Heat:	Select Gas Electric Central Woodstove Only
Type of Cooling:	Select Air Evap Cooler Central
Woodstove or Fireplace?	Select Woodstove Fireplace Both None
How many Chimneys?
Is Home on City Water or Well?	Select City Water Well Water
Type of Garage:	Select Attached Not Attached Car Port
Size of Garage:	Select One Car Two Car Three Car
Is Home Sprinklered?	NoYes
Fire or Security Alarm?	Select Fire Security Both None
Local or Central?	Select Local Central
Any Losses in Last Five Years?	NoYes
Provide Date, Type, and Amount For Any Losses:
Any Animals?	NoYes
If 'Yes' What Type?

Information Needed For Reply

Email:
Name:
Address:
City:
State:
Zip:
Phone:	--
Fax:	-- * Not Required
How did you find our web site ?	Please Select Alta Vista Another Insurance Company Aol Search Ask Jeeves Excite GoTo Net Google Hotbot Infoseek Lycos MaMa MetaCrawler Netscape Search NorthernLight Referred by someone Starting Point Webcrawler Yahoo Yellow Pages Other (Please specify below...)  * Not Required
Any Further Questions or Information:

If you have any questions E-mail us at

mail@hanninsurance.com

or call our direct telephone line at (760) 365-9744.
IMMEDIATE RESPONSES ON ALL QUOTES. WE CAN SAVE YOU MONEY
Disclaimer: All quotes are subject to change. Quotes are based on the information
you provide. Please be as accurate as possible so we can be as accurate as we can.

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