845-Insurance.com

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845-Insurance.com
39 Maple Ave.
New City, NY 10956
(845) 638-6200
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Renter's Insurance Quote Request

Name
Address of Property
Current Address
Day Time Phone
Evening Phone
Email Address
Occupation
Marital Status
Self-Described Credit History	Excellent Average Poor
Type of Residence
Number of occupants
Dog	Yes No
Desired Amount of Coverage for personal property
Liability limits
Jewelry valued over $1000	Yes No
Business on Premises	Yes No
Deductible
Insurance required by landlord	Yes No
Current rental lease expiration date
Monthly Rent Payment
Timeline to become a homeowner
Include multi policy discount for insuring your cars with us as well	Yes No
Preferred Contact Time
Comments…
You may be contacted to verify additional information. For everyone’s courtesy please only submit serious requests.