Homeowner's Insurance Quote

Statewide Insurance Services

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Homeowner's Insurance provides coverage for your home against fire, lightning and other perils. Fill out the form to the best of your ability and someone will call you within 24 hours.

HOMEOWNER'S QUOTE

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Date of Birth *

Social Security Number *

Do you currently have insurance? *

Yes No

If yes, what company are you with? *

Marital Status *

Married Divorced Single

Number of people living in the household *

How did you hear about this site? *

Internet Search Advertisement Friend Other

If Other please specify: *

Building Information

Date Purchased *

Purchase Price *

Year of construction *

Square Feet *

How many acres does the property sit on? *

Roof Type *

Construction Type *

Garage *

Pets *

Yes No

If yes, What type of pets? *

Do you have a pool? *

Yes No

Coverage Information

How much do you want to insure the home for? *

How much liability coverage do you want? *

No Liability $100,000 $300,000 $500,000

Which deductibles are you most comfortable with? *

$500 $1,000 $2,500 $5,000 More than $5,000

If you would like to expedite the process, please upload a copy of your current declarations page. *

Max file size: 20MB

Submit

Statewide Insurance Services

16230 Highway 603, Suite B
Kiln, MS 39556
MAILING: PO BOX 277, KILN, MS 39556

Contact Us

PHONE: 228.255.1188
FAX: 228.255.5753
EMAIL: agent@statewideinsms.com

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Home
Quotes
Contact
- Contact Us
- Company Claim Numbers
En español
About Us
- About Us
- Testimonials
MAKE A PAYMENT

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