Home Owners Insurance Quote

Name
First Last
Address
Street Address City State ZIP Code
County
Email
Home Phone
Work Phone
Date of Birth
MM slash DD slash YYYY
Marital Status
- Single
- Married
Spouse's Name
First Last
Type of Home
- 1 Story
- 1.5 Story
- 2 Story
- Tri-Level
- Quad Level
Type of Construction
- Frame
- Brick
- Stucco
Type of Siding
- Aluminum
- Steel
Current Dwelling Coverage
If new homeowner, leave blank.
Deductible
If new homeowner, leave blank.
Year Built
Total Square Feet
Main Floor Square Feet
Basement
- Finished
- Unfinished
- None
Garage
- Unattached
- Attached
- None
Holds how many vehicles?
- 1
- 2
- 3
Porch
- Yes
- No
Type of Porch
- Covered
- Uncovered
Size of Porch
Deck
- Yes
- No
Type of Deck
Size of Deck
Central Air
- Yes
- No
Type of Heat
- Natural Gas
- Electric
- L.P. Gas
- Oil
- Wood
Heat - Year Updated
Fireplace
- Yes
- No
How Many Fireplaces?
What type of fireplaces? (select all that apply)
- Gas
- Wood burning
- Other
Explain other type of fireplace
Number of Bathrooms
- 1
- 1.5
- 1.75
- 2
- 3
Plumbing - Year Updated
Roof Type
Roof - Year Updated
Electrical
- Fuses
- Circuit Breaker
Amps
Electrical - Year Updated
Value of Personal Property
Miles for Fire Department
Recreation Vehicles
- Boat
- Snowmobile
- 4-Wheelers
If you have any items of special value (jewelry, silverware, guns, antiques, fine arts, collectibles) that you would like insured, please list here
Are any business or professionals conducted on the premises?
- Yes
- No
If yes, please describe
Is any buisness property kept on the premises?
- Yes
- No
If yes, please describe
Loss History Information
Date
MM slash DD slash YYYY
Type of Loss
Amount
Add a second loss?
- yes
- no
Date
MM slash DD slash YYYY
Type of Loss
Amount
Add a third loss?
- yes
- no
Date
MM slash DD slash YYYY
Type of Loss
Amount
Please remember by submitting an application for a quote does not provide or bind coverage.
Be advised by submitting your application, you agree to receive a phone call from our office for some additional personal information to give the best quote options Citizens Ins. Agency has to offer.

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Contact

102 Main St South
PO Box 339
Hutchinson, MN 55350

Phone 320-587-2674
Toll 888-234-2910
Email [email protected]

Hours

Monday-Thursday
8:30am–5:00pm

Friday
8:30am–4:00pm

A wholly owned subsidiary of Citizen Bancshares of Hutchinson, MN, Citizens Insurance Agency welcomes the opportunity to help you with all of your insurance needs. Citizens Insurance Agency products are not FDIC insured, are not insured by any federal agency, are not deposits of Citizens Bank, are not guaranteed by Citizens Bank, and may lose value.

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Loss History Information

Contact

Hours