Homeowners Insurance Quote Form

Builds a full picture of a property — construction, heating, floor area, condition and claims history — so an agent can price cover accurately. Owners answer once and may attach their current policy when they want a side-by-side comparison of coverage.

Use this template

Name

Nombre

Apellido

Date of birth

What is your home address?

Dirección

Ciudad

Estado / Provincia

Código postal

Do you rent or own it?

I own it I rent it

Year purchased

Are you closing on a new home or simply switching insurers?

Closing on a new home Switching insurer Taking out my first policy Just comparing prices

What type of property is it?

Primary residence Secondary home Rental property Holiday home

What type of building is it?

Single-family house Townhouse Condominium unit Duplex Mobile or manufactured home

Number of storeys

What is the floor area of your home?

Total area of outdoor porch or deck

Who lives in your home?

The owner only The owner and family Tenants Shared with housemates

How would you describe the condition of the exterior and interior?

Excellent Good Average Needs work

Type of construction

Type of siding

When was your house built?

How do you heat your home?

Where is the tank located?

In the basement In the garage Outside, above ground Underground There is no tank

Age of the boiler

What breed are your dogs?

Has the home had major renovations, and when?

Describe the work that was carried out

Do you have any of the following?

If you wish, we can match the cover of your current policy

Yes, match my current policy No, build a fresh quote Not sure yet

Would you rather upload your current policy or type the details?

Upload the document Type the details

Upload a copy of your current policy so we can review and compare it

Max 10 MB per file

Have you filed a home or property claim in the last 5 years?

Yes No I do not recall

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