Homeowners Quote

The Christian Baker company is a full service insurance and bonding agency located in Central, PA.

Please fill out the following information:

Name:
Social Security Number:
Address

City
State
Zip
Distance to fire Department

Year Built
Style of Home If other which style?
Number of Families
Exterior wall material
Garage # Cars Attached?
Number of Porches Small Medium Large

Type of heat
Number of Fireplaces Gas Wood

Do you have a swiming pool Yes No
If yes how deep? ft
Is the pool fenced in? Yes No

Date of birth:
Marital Status
Home Phone Number
Cell Phone Number
County
Township
Fire Department
Distance from fire hydrant (in feet)

Square Footage
Foundation
Roof Material
If other:
Number of Decks Small Medium Large

Central Air Yes No
Number of bathrooms Full ¾ ½

Do you have a trampoline? Yes No
Do you have any dogs? Yes No
If yes, what is the breed of dog
Renovation Dates on Home

Roof

Wiring

Heating

Plumbing

Who is your current homeowners's insurance carrier? Who is your current automobile insurance carrier? Is your insurance and taxes currently escrowed? Yes No
How much do you owe on your mortgage?