Home/Dwelling Insurance Quote

Complete the form below and our team will review your information and reach out to discuss your coverage options.

Applicant Information

Applicant Name *

Co-Applicant Name

Mailing Address *

Phone *

Email *

Effective Date

Property Information

Property Address *

Year Built

Home Type

Exterior

Roof Type / Age

Heating Type

Occupancy *

Are there other structures needing coverage? Describe and note coverage needed.

Update years for the following (leave blank if no updates)

Electrical

Plumbing

Heating/Air System

Roof

Are there business operations being conducted on the property?

Yes No

Property hazards/animals (select all that apply and provide details)

Swimming pool?

Yes No

Horse?

Yes No

Trampoline?

Yes No

Dog?

Yes No

If yes, dog breed

Is there a wood stove/fireplace in use at any time?

Yes No

Are you requesting Replacement Cost or Actual Cash Value coverage?

Replacement Cost Actual Cash Value

Deductible Requested

Prior Insurance

Prior Carrier Name

Prior Policy Expiration Date

Claims History (type and year)

Is there a Mortgagee / Lienholder?

Yes No

Farmers Mutual Insurance Company logo

Local insurance you can trust since 1898. Farmers Mutual Insurance Company serves Granville, Person, Vance, Warren, Wake, and Franklin counties with home, farm, and fire coverage.

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Contact

(919) 693-7535
126 Hillsboro Street
Oxford, NC 27565

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