Save More Insurance - Renters Insurance Quote Request
For Washington and Idaho Residents

No coverage is bound until you are contacted by one of our representatives


 CONTACT INFORMATION
* Name  
* Street Address  
* City, State & Zip  
* Phone Number   Home   Cell 
* Date of Birth  
* Social Security #     
* Occupation  
 Employer  
SPOUSE INFORMATION
 Name  
 Phone Number   Home   Cell 
 Date of Birth  
 Social Security #     
 Occupation  
 Employer  
 PROPERTY INFORMATION
 a. How many units in the complex  
 b. How many units in your building?  
 c. Is there a fire wall between units?  
 d. Is there an Apartment or Condo Association?  
RATING INFORMATION
 1. What year was this dwelling built?
 2. What type of dwelling?
 3. What type of construction?
 4. Do you have a fireplace?
      If yes, please describe what type
 5. Do you have a woodstove?
 6. What is the primary source of heat?
 7. What is the secondary source of heat?
 8. Do you have a security system?
      If yes, please describe what type
 9. Have you had any losses in the past 3 years?
      If yes, please describe
 10. Do you have insurance now?
 11. Do you own any pets?
    If yes, Please describe 
COVERAGE INFORMATION
 1. What is the total value of your personal property? $
 2. Do you want earthquake coverage?
 3. Do you have collections worth over $500?
    If yes, Please describe 
 4. Do you have any single piece(s) of jewelry valued over $500?     
    If yes, Please describe 
 5. Do you have work tools that need coverage?
    If yes, Please describe 
 6. Do you operate a business out of your residence?
    If yes, Please describe 
ADDITIONAL INSURED
 Name  
 Address  
 Phone Number   Phone    Cell:
Please use the space below to add comments
regarding any special circumstances or coverage needs
 

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