Home Insurance - Otte Family Insurance

First Named Insured:

First Name *

Middle Initial

Last Name *

Address: Street, City, State, Zip *

Address Line 1

City

State

Zip Code

Email *

Phone Number *

How long at current address *

Previous address if less than 2 years at current address

Date of Birth *//

Drivers license Number and State *

Social Security Number

(For most accurate quote. We can also call you for this if you want)

Gender *

Male
Female

Status *

Education level

(optional possible discount)

Occupation

(Optional)

Will there be another person on policy?

2nd Named Insured:

First Name *

Middle Initial

Last Name *

Address: Street, City, State, Zip *

Address Line 1

City

State

Zip Code

Email *

Phone Number *

How long at current address *

Previous address if less than 2 years at current address

Date of Birth *//

Drivers license Number and State *

Social Security Number

(For most accurate quote. We can also call you for this if you want)

Multiple Choice *

Male
Female

Status *

Education level

(optional possible discount)

Occupation

(Optional)

HOME Quote

Current Carrier

(optional)

Primary Residence?

Current liability coverage limit

(optional)

What kind of coverage do you want? *

Year built

Members in household *

You have a Dog?

If Yes, what is bread of each dog?

(ineligible breeds: Akitas, American Bulldogs, Chow Chow, Doberman Pinchers, Mastif, Pit Bulls, Rottweilers, Staffordshire Terrier, Wolf hybrid, or a mix or variation of these breeds, any dog with a history of biting or any dog underwriting deems ineligible)

Purchase/rental date//

Square Feet NOT including Basement

Basement?

If Yes Basement, how many basement Square Feet?

If Yes Basement, How many Square Feet of basement is finished?

Number of stories

Number of bathrooms

How many Full Bathrooms?

How many Half Bathrooms?

How many ¾ Bathrooms? (bathrooms with a shower only instead of bathtub)

Siding Type

Size of Garage? How many car garages?

Number of Solar panels

Roof Type

Last year roof was replaced *

Hail Resistant roof?

(must provide proof if Hail Resistant)

How is your home heated? *

A/C or Swamp cooler? Which one? *

Trampoline *

Swimming Pool *

Hot Tub *

Miles to nearest Fire Station

(Required if you live in a rural location)

Feet to nearest Fire Hydrant

(Required if you live in a rural location)

Any Smokers

Electrical updates since home was built? If yes, what year?

Plumbing updates since home was built? If yes, what year?

Do you live in a gated community?

If gated community, is it guarded?

Is your community actively guarded?

For most accurate results upload your current Home declaration page Here

Click or drag files to this area to upload. You can upload up to 3 files.

(Optional)

Fill out the form below: