Prescott & Craig Insurance

101 East Main
Jerome, ID. 83338
1-208-324-7000
info@prescottandcraig.com

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ONLINE HOMEOWNERS QUOTE FORM

Full Name:

Phone Number:

Physical or Mailing Address: (street, city, zip)

Email Address:

Property Address:

Primary
Secondary

Year Built:
Number of Stories:
Ground Floor Area:

Frame
Brick
Other:

Foundation:

Type of Roof:
Age:
Finished Attic:
Attic Area:

Porch or Deck:
Area:
Open or Closed:

Fireplace or Woodstove:

Number of Hearths: Number of Chimneys:

Type of Heating:

Full Baths:
Half Baths:

Garage or Carport:
Number of Cars:
Attached or Detached:

Air Conditioning:
Ducts:

Prior Insurance Carrier:

Policy Number:

Any Losses:

Updates:

Birthdates:

Social Security Numbers:

Acreage:
Used for what:

Comments/Questions:

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Prescott & Craig Insurance
101 East Main - Jerome, ID 83338
1-208-324-7000
info@prescottandcraig.com

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