Serving Massachusetts since 1983
GUARD INSURANCE AGENCY
(617)926-4000                                        Expert, friendly & helpful insurance services.    
Independent Insurance Agent


Homeowners Information Form
Personal Information
First Name: 
Last Name: 
Mailing Address: 
City:    State:    Zip: 
What year were you born:   
Day Phone:    Cell Phone: 
Email: 

Property Information
Property address: 
City:     State:    Zip: 
Home square footage:  sq. ft.  
Year built: 
How long have you owned the home:   years
Do you occupy this home:  Yes  No 
Pets:  Yes  No   If yes, please Specify: 
Number of claims in last 5 yrs: 

Property Structure Information
Structure Type
Structure Category
Construction
Roof
Garage
Age: 
Type: 

Features
Bathrooms
Heating System
Deck/porch/patio
Fireplaces
# of Full Baths: 
# of Half Baths: 
Deck Sq. Ft.:    
Porch Sq. Ft.:    
Enclosed Patio Sq. Ft.:    
# of Chimneys:    
# of Hearths:    

Additional Features
Pool
Central Air
Central Vac
Security Alarm
Fire Alarm
Smoke Detector
Yes
Yes
Yes
Yes

Additional Comments

   


Home Page | Auto Insurance | Homeowners Insurance | Condo Insurance | Condo Association Insurance | Renters Insurance |
Business Insurance | Contractors Insurance | Restaurant Insurance | Religious Institution Insurance |
Get a Quote | Contact Us | About Us | Directions | Useful Links | Privacy


Guard Insurance Agency, 279 Mount Auburn Street, Watertown Massachusetts 02472
Copyright © Guard Insurance Agency, 2010. All Rights Reserved