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Home Coverage

Step 1 of 7 - Personal Info

Step 1 of 7Personal Info

Your Home Protection Plan

This lets a licensed Arizona advisor match the quote to you, not a generic lead form.

Step 1 - Personal Info: your advisor uses this to verify eligibility and keep the quote secure.

Add-on requested from landing:

CLIENT DETAILS

Email Address

Phone Number

First Named Insured

Date of Birth

Occupation

Employer

CO-APPLICANT

Add Co-Applicant

Spouse or partner details

Add Person

Remove

Second Insured Name

Date of Birth

Occupation

Employer

LOCATION

Property Address

City

State

Zip Code

USAGE

Primary

Your main residence.

Secondary

Vacation or second home.

Rented

Tenant occupied property.

Dwelling Type

New Purchase?

PROPERTY SPECS

Year Built

Square Footage

Construction

Roof Type

Roof Shape

Foundation

SAFETY FEATURES

Fire StationWithin 5 miles

HydrantWithin 1000 ft

Burglar AlarmMonitored

Fire AlarmMonitored

LOSS HISTORY

Report any losses in the last 5 years.

Number of Losses

CURRENT POLICY (OPTIONAL)

Current Carrier

Dwelling Limit

No declaration page needed right now.

Your advisor will ask for this information after showing your options, only if it helps confirm the final rate.

VALUABLES (OPTIONAL)

Select items to add specific coverage.

Jewelry

Rings, Watches, Necklaces

Blanket Limit ($)

Itemized Limit ($)

Kept in Bank Vault?

YesNo

OTHER ITEMS

Furs

Fine Arts

Silverware

Cameras

Collectibles

Other

COVERAGE PATH

Personal Information
Location & Usage
Property Specs
Safety Features
Loss History
Current Policy
Valuables

Bundle & Save

Crunching the numbers...

Alex Tip: Did you know combining your Auto and Home insurance with the same carrier can save you up to 20%? Ask about the multi-policy discount.

SCANNING

PROPERTY BLUEPRINT 1/1

While We Find Your Rates

Your request ID: #AX-HOME-2026. Stephanie is comparing 15+ Arizona home carriers now.

Home + Auto Bundle Check

Bundling auto + home saves an average $340/yr.

Your advisor will compare both options, handle escrow paperwork, and keep broker fees at $0.

Auto+ Home=$340/yr avg

Senior Agent AssignedStephanie M.Reviewing your application...

Submitted

Agent Review

Issuance

Expect a verification call within 10-15 minutes.

A confirmation email has been sent to you.