Homeowners Insurance Quote

Complete the short form below and a local agent from the Gerry Smith Insurance Agency will follow up with competitive homeowners insurance options — no obligation.

What this quote reviews

A Minnesota homeowners policy is more than the dwelling. Contents (personal property), liability, loss of use and optional endorsements all sit on the same form. If you keep jewelry, watches, collectibles, firearms or fine art, use the additional-coverage fields later in this form — standard special limits on those items are often lower than people expect. For a plain-language walkthrough of sublimits and scheduled items, see covering jewelry and personal property.

Personal Information

First Name

Middle Init

Last Name

Address

City

State

ZIP Code

Date of Birth

Spouse's Date of Birth

Spouse's Social Security Number

Disclaimer

Yes No

Non- Smoker

Yes No

Vehicle Information

Year Built

Quote Details

Social Security Number

Dwell Amt

Ext Repl

Yes No

Sep Struct

Pers Prop

Cont Repl

Yes No

Loss Of Use

Sewer/ Drain

Addl Cov1 Amt

Addl Cov2 Amt

Addl Cov3 Amt

Mkt Value

Claim 1 Date

Claim 1 Descr

Claim 2 Date

Claim 2 Descr

Claim 3 Date

Claim 3 Descr

Liab

Guest Med

Addl Cov1

Addl Cov2

Addl Cov3

Child Care

Ded

Current Ins Co

Prot Dev1

Prot Dev2

Contact Information

Phone

Fax

Mailing Address / ZIP

Comments

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