Texas Community Insurance Group by Hoffman Financial Services, Inc. | Tel (972)758-9300 Fax (972)758-9355 | 1400 Preston Rd, Suite 345 Plano, Texas 75093

THE POWER OF PROTECTION972-758-9300
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Home Owner's Quote

Contact Information
Name: Phone:        
Mailing Address: City: State: Zip:
Location Address: City: State: Zip:
E-Mail:

If you have lived at the above address for less than 3 years, please provide your prior address below:.
Previous Address: City: State: Zip:

Following forms are optional, Please fill in if you would like to provide more information.

Current Insurance Information

Current Insurance Company
(not agency)

Date Current Policy Expires

mm/dd/yyyy


Property a Townhouse?

Yes No

If Yes -

Number of units in your building

 

Residence Usage

Primary Secondary

Protection Devices Installed*

Smoke Detectors

Dead Bolts

 

Fire Extinguisher

Central Burglar / Fire Alarm

If NO -

Located within the fire district.


Liability Coverage Limit

$

Deductible

$

 

High Value Items
(Item, Value)

 These are high value items that need to be specifically identified, including jewelry, silverware, collectibles, furs, etc. Please list each item and its value.

 

Home updates

Updates: Year of update: Partial: Complete:
Heating
Electric
Plumbing
Roof


 
Thank You!
Texas Community Insurance Group by Hoffman Financial Services, Inc. | Tel (972)758-9300 Fax (972)758-9355 | 1400 Preston Rd, Suite 345 Plano, Texas 75093
TDI License Numbers: 1486816/1381618 | Home | About Us | Business | Life/Health | Individual/Family | Contact Us |