Kenyon Insurance Homeowners Quote Form

Please complete the online form below. Be sure to complete all applicable boxes an click on the "Send to Kenyon Insurance" button at the bottom of the form. One of our agents will contact you with a quote.  We may ask for your social security number when we contact you if you do not feel comfortable sending that information over the internet.

Name:
Mail Address:
City State and Zip:
Property Address:
City State and Zip:
Home Phone:
Business Phone:
Social Security Number:
How did you hear about us:
New Purchase: No Yes
Presently Insured: No Yes
Company and Policy No:
Who was previous Owner:
Date requested or closing date:
Underwriting Information:
Underwriting Info Part 2:
If occupied how many:
Year Built:
Type of home:
How many stories:
Square footage or Dimensions:
Acreage:
Roof Type:
Roofing Matereial:
Central Heat: No Yes
Type of Heating:
Fuel:
Basement Full: No Yes
If yes number of square feet:
Crawl Space: No Yes
If yes number of sq ft:
Finished basement: No Yes
If yes amt of square feet:
Partially finished basement: No Yes
If yes number of sq feet:
Other Basement Options:
Siding:
Attachment Deck: No Yes
If yes state size of deck:
Attachment Porch: Yes open Yes closed No
If yes state size of porch:
Patio: No Yes
Breezeway: No Yes
Attached Garage: No Yes
If yes state size of garage:
Carport: No Yes
Dormers: No Yes
Living Room: No Yes
Kitchen: No Yes
Dining Room: No Yes
Specialty Rooms state type:
Number of Bedrooms:
Number of Full Baths:
Number of Half Baths:
Laundry Mud Room: No Yes
Large Attic: No Yes
Fireplace: No Yes
Security System: No Yes
Central Air: No Yes
Central Vacuum: No Yes
Smoke Alarms: No Yes
If yes how many:
Wood Burning Stove: No Yes
Business conducted on premises: No Yes
If yes please indicate type:
Electrical system renovated: No Yes
If yes state year:
Plumbing system renovated: No Yes
State year if yes:
Heating system renovated: No Yes
If yes state year renovated:
Roof renovated: No Yes
State year renovated if yes:
Other buildings on premises: No Yes
If garage state number type:
If shed state number and type:
If barn state number and type:
If other state number and type:
Swimming Pool: Yes Above Ground Yes Below Ground No
Is pool fenced: No Yes
Trampoline: No Yes
Do you own any dogs: No Yes
If yes how many and breed:
Any other animals:
How many feet from hydrant:
Number of miles from station:
Losses last 5 yrs to property: No Yes
If yes date type amt of loss:
Ever had coverage DECLINED: No Yes
Ever had coverage CANCELLED: No Yes
Ever had coverage NON RENEWED: No Yes
If yes date type and reason:
Directions to property:
 

Thank you for choosing Joseph J. Kenyon, Inc. for your homeowners insurance quote!