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Welcome to Mullen Insurance Agency Inc.

 

 

Homeowners

Quick Quote Sheet

 
Applicant Information            
I am: Home values over $250,000 require Accord applications!
  Your Name:

       required!            Email Address:    (retail customer or producer/agent)

Customer Information            
Your Name: Spouses Name:
Social Security # Spouses Social Security #
Date Of Birth: Spouses Date of Birth:

Location/Contact Information 
Property Address: City:
County: State:   

Currently available in Texas only.
Zip: 

 

 

 Inside City Limits?

 

 
phone: alt. phone:
email: Fax:

Building  Information            
Year Home Built:  Square Footage:
Construction Type: Furnace Age:
Roof Type: Roof Age:
Swimming Pool on Property? Trampoline on   Property?
Pets on Property? Type:
 Closest Fire Hydrant: Closest Fire Department:
Monitored Alarm?

Updates

                  complete if home is over 20 years old
What year was plumbing updated?
What year was electrical updated?
Other updates?

Coverages                                                     
Amount of Coverage needed:   

Home values over $250,000 require Accord applications!

3-Year Prior Carrier and Loss History 

if no losses, say NONE or NA
Carrier Loss amount & description 
Expiring
1st Prior
2nd Prior

Additional Information